Introduction Excessive noise in operating theatres poses a significant challenge to communication, cognitive function and patient safety. Multiple sources contribute to excessive noise in the operating room including equipment and personnel. This study sought to define the noise within the operating room and elucidate factors contributing to excessive noise.

Methods This observational study sampled 44 surgical procedures across various surgical specialties and measured the noise level throughout each case using a Decibel X Recorder App (iPhone) recorder over a 2-week period. The number of staff, procedure type, duration of case, theatre staff composition and noise levels were recorded for each case. A correlation analysis of the listed factors and a linear regression were performed to model the observed noise and contributing factors for the collected cases.

Results This study systematically quantifies intraoperative noise levels across 44 surgical procedures during a two-week period, assessing key contributors such as staff presence and procedure type. The time-weighted average noise level was 65.13 dB(A), substantially exceeding the recommended 35 dB threshold. Regression analysis revealed that each additional theatre staff member increased noise levels by 0.82 dB(A) (Time Weighted Average) (β = 0.818, p = 0.021), while procedure duration had no significant impact. Although noise levels varied across surgical specialties (p = 0.0185), no specific discipline exhibited statistically higher exposure.

Conclusions These findings highlight the need for targeted noise-reduction strategies, including optimising team composition, limiting non-essential communication and incorporating sound-dampening materials to enhance surgical efficiency and patient outcomes.