Impact of Anesthesia Alarm Volume on Mental Workload in Surgical Trainees
NCT ID: NCT07089485
Last Updated: 2025-09-25
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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NOT_YET_RECRUITING
NA
26 participants
INTERVENTIONAL
2025-09-25
2026-09-26
Brief Summary
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Detailed Description
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Previous studies have examined the effects of background noise and music on surgical performance, with some showing that certain types of music can reduce stress or improve focus. However, the specific impact of anesthesia alarm sounds especially when they are excessively loud or frequent remains poorly understood. These alarms may distract surgical teams, particularly trainees, and contribute to increased cognitive load, potentially impairing performance during surgical procedures.
Cognitive load refers to the amount of mental effort being used in working memory. In the operating room, excessive cognitive load can hinder performance, decision-making, and reaction time, particularly in complex or high-pressure situations. Understanding how to manage and optimize environmental factors that influence mental workload is therefore essential, especially for surgical trainees still developing their skills.
This randomized pilot interventional study aims to investigate the effect of anesthesia alarm sound intensity on the mental workload of novice surgeons performing simulated procedures. By focusing on surgical trainees working on a high-fidelity simulator, we aim to create a controlled yet realistic environment to assess the cognitive impact of varying alarm volumes.
The study will compare two conditions: an optimized alarm sound level and a higher-level alarm sound (above ambient noise). Participants will be randomly assigned to one of these conditions during their simulated surgical tasks. The primary outcome is the cognitive load experienced by the trainees under each condition.
To comprehensively assess cognitive load, both objective and subjective tools will be used. Objective measures will include heart rate variability (HRV) and pupillometry two physiological indicators of stress and cognitive effort. Subjective cognitive load will be measured using validated scales such as the NASA Task Load Index (NASA-TLX) or its surgical adaptation, the SURG-TLX. These tools evaluate dimensions such as mental demand, effort, frustration, and performance.
By combining physiological data with subjective reports, the study seeks to capture a multidimensional understanding of how alarm noise affects surgical trainees. The ultimate goal is to determine whether reducing the intensity of auditory alarms while maintaining their effectiveness can minimize unnecessary cognitive strain and distraction during procedures.
The findings of this study are expected to inform future recommendations regarding auditory ergonomics in operating rooms. Establishing evidence-based guidelines for alarm sound levels could contribute to a safer, less stressful working environment for surgical teams. This is particularly important in the training context, where the balance between realism and cognitive manageability is crucial for learning and performance.
In conclusion, this pilot study addresses a critical and underexplored aspect of the surgical environment: the cognitive impact of anesthesia alarm noise. By evaluating its effects on novice surgeons, the research aims to promote better alarm management strategies, improve working conditions, and ultimately enhance both patient safety and surgical education.
Conditions
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Study Design
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NA
SINGLE_GROUP
OTHER
NONE
Study Groups
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surgical trainees group
The study group consists of surgical trainees with limited experience in simulated surgery. They will perform multiple 15-minute surgical sequences in a controlled environment, where anesthesia alarm sound levels will vary between 64 and 75 dB(A). These sound levels will be randomized across the sequences to assess the impact of noise on their mental workload, concentration, and surgical performance.
effects of sound
The surgical trainees will perform four 15-minute surgical sequences in a controlled environment, with varying sound levels (64, 67, 73, and 75 dB(A)) randomized across the sequences to assess the surgeons' responses.
Interventions
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effects of sound
The surgical trainees will perform four 15-minute surgical sequences in a controlled environment, with varying sound levels (64, 67, 73, and 75 dB(A)) randomized across the sequences to assess the surgeons' responses.
Eligibility Criteria
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Inclusion Criteria
* Surgeons with normal hearing;
* Surgeons capable of performing surgical sutures (regardless of skill level);
* Surgeons able and willing to follow all study procedures according to the protocol;
* Surgeons who have understood, signed, and dated the informed consent form provided on the day of enrollment.
Exclusion Criteria
* Surgeons with known cardiac pathology;
* Surgeons who do not consent to participate in the study;
* Surgeons with known hearing problems;
* Surgeons who fail the hearing test;
* Surgeons who worked on-call or night shifts during the night before the evaluation day.
* Surgical trainees at the Lorraine Cancer Institute.
* Adults under legal protection (guardianship, curatorship, or legal supervision);Persons deprived of liberty;Pregnant or breastfeeding women.
18 Years
ALL
Yes
Sponsors
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Institut de Cancérologie de Lorraine
OTHER
Responsible Party
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Principal Investigators
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Frédéric MARCHAL, Pr.
Role: PRINCIPAL_INVESTIGATOR
Institut de Cancérologie de Lorraine
Nour Mammari Halabi, PhD.
Role: STUDY_CHAIR
Institut de Cancérologie de Lorraine
Central Contacts
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References
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Roche TR, Said S, Braun J, Maas EJC, Machado C, Grande B, Kolbe M, Spahn DR, Nothiger CB, Tscholl DW. Avatar-based patient monitoring in critical anaesthesia events: a randomised high-fidelity simulation study. Br J Anaesth. 2021 May;126(5):1046-1054. doi: 10.1016/j.bja.2021.01.015. Epub 2021 Apr 8.
Torabizadeh C, Yousefinya A, Zand F, Rakhshan M, Fararooei M. A nurses' alarm fatigue questionnaire: development and psychometric properties. J Clin Monit Comput. 2017 Dec;31(6):1305-1312. doi: 10.1007/s10877-016-9958-x. Epub 2016 Nov 15.
Way TJ, Long A, Weihing J, Ritchie R, Jones R, Bush M, Shinn JB. Effect of noise on auditory processing in the operating room. J Am Coll Surg. 2013 May;216(5):933-8. doi: 10.1016/j.jamcollsurg.2012.12.048. Epub 2013 Mar 18.
Whitham MD, Casali JG, Smith GK, Allihien AL, Wright BW, Barter SM, Urban AR, Dudley DJ, Fuller RR. Noise in cesarean deliveries: a comprehensive analysis of noise environments in the Labor and Delivery operating room and evaluation of a visual alarm noise abatement program. Am J Obstet Gynecol MFM. 2023 May;5(5):100887. doi: 10.1016/j.ajogmf.2023.100887. Epub 2023 Feb 11.
Schmid F, Goepfert MS, Kuhnt D, Eichhorn V, Diedrichs S, Reichenspurner H, Goetz AE, Reuter DA. The wolf is crying in the operating room: patient monitor and anesthesia workstation alarming patterns during cardiac surgery. Anesth Analg. 2011 Jan;112(1):78-83. doi: 10.1213/ANE.0b013e3181fcc504. Epub 2010 Oct 21.
Katz JD. Noise in the operating room. Anesthesiology. 2014 Oct;121(4):894-8. doi: 10.1097/ALN.0000000000000319. No abstract available.
Lamotte AS, Essadek A, Shadili G, Perez JM, Raft J. The Impact of Classroom Chatter Noise on Comprehension: A Systematic Review. Percept Mot Skills. 2021 Jun;128(3):1275-1291. doi: 10.1177/00315125211005935. Epub 2021 Mar 27.
Fu VX, Oomens P, Sneiders D, van den Berg SAA, Feelders RA, Wijnhoven BPL, Jeekel J. The Effect of Perioperative Music on the Stress Response to Surgery: A Meta-analysis. J Surg Res. 2019 Dec;244:444-455. doi: 10.1016/j.jss.2019.06.052. Epub 2019 Jul 18.
El Boghdady M, Ewalds-Kvist BM. The influence of music on the surgical task performance: A systematic review. Int J Surg. 2020 Jan;73:101-112. doi: 10.1016/j.ijsu.2019.11.012. Epub 2019 Nov 22.
Oomens P, Fu VX, Kleinrensink GJ, Jeekel J. The effect of music on simulated surgical performance: a systematic review. Surg Endosc. 2019 Sep;33(9):2774-2784. doi: 10.1007/s00464-019-06868-x. Epub 2019 May 28.
Other Identifiers
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2025-A01256-43
Identifier Type: -
Identifier Source: org_study_id
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