Abstract
OBJECTIVE: This study aimed to evaluate the effects of operating room (OR) noise management on intraoperative somatosensory evoked potential (SSEP) stability and postoperative pain management among patients undergoing spinal surgery. METHODS: A retrospective study was conducted on 158 patients undergoing spinal surgery between March 2023 and December 2024. Participants were stratified into high-noise exposure (conventional OR environment, n = 78) and low-noise exposure groups (noise-controlled OR environment, n = 80) based on implemented noise management protocols. Noise exposure levels, intraoperative SSEP parameters (latency, central conduction time (CCT), peak amplitude, and signal-to-noise ratio), postoperative pain scores measured using a visual analog scale, analgesic consumption, patient satisfaction measured by Patient Satisfaction Questionnaire-18, functional recovery assessed by Spine Functional Index-25, and recovery outcomes were compared between groups. RESULTS: The high-noise exposure group had significantly impaired SSEP stability with increased prolonged SSEP latencies and CCTs than the low-noise exposure group (P < 0.001). The high-noise exposure group demonstrated significantly higher postoperative pain scores, increased analgesic consumption, prolonged hospital stays, and lower patient satisfaction scores (all P < 0.001). Although functional impairment was greater in the high-noise group at discharge (P < 0.001), both groups achieved comparable functional recovery at 1-month follow-up (P > 0.05). Postoperative complications showed no significant difference between the groups (P > 0.05). CONCLUSION: Management of OR noise is associated with improved intraoperative SSEP monitoring stability and reduced postoperative pain in spinal surgery patients. Noise-controlled environments may enhance early recovery without affecting complication rates. Results support the implementation of systematic noise reduction protocols in perioperative care.