Changes Of Cardiac Function In Perioperative In Elderly Patients By Ultrasound Cardiac Output Monitor

Objective Ultrasound cardiac output monitor(USCOM) to can be used to observeâ‘ the influence of the different general anesthetic inductionon cardiac function in elderly patients.â‘¡the changes of cardiac function of the elderly hypertensive patients in different risk stratification of perioperative period so as to optimize the effect of clinical treatment.Methods Part one : compared with the influence of the different general anesthetic inductionon cardiac function of elderly patients. Selected 75 cases with non-cardiac surgery of American Anesthesiologist Association(ASA)Ⅰ～Ⅱin aged patients, then divided them into there groups stochasticlly, sevoflurane group (S), propofol group (P) and midazolam group (M),with 25 cases in each.These three groups were monitored the left ventricular cardiac output (CO), stroke volume (SV), systemic vascular resistance (SVR),velocity peak (Vpk), ejection time(ET) percent, heart rate (HR) situation by USCOM in five time points including before the induction of general anesthesia (T₀), before intubation 1min (T₁), after intubation 2min (T₂), after intubation 5min (T₃),and after intubation 10min(T₄).Part two : studied on the cardic function change of hypertenssive elderly patients from different risk stratification of perioperative period. Elderly hypertensive patients with no cardiac surgery were selected and divided into the following 4 groups: groupsâ… (low-risk), groupâ…¡(dangerous), groupâ…¢(high-risk) and control group (without hypertension), each group with 30 cases. These four groups were monitored the left ventricular cardiac output (CO), stroke volume (SV), systemic vascular resistance (SVR),velocity peak (Vpk), ejection time(ET) percent, heart rate (HR) situation by USCOM in seven time points including before the induction of general anesthesia (T₀), before intubation (T₁), immediately after intubation (T₂), the beginning of operation ( T₃ ), intraoperative 1 hours ( T₄ ), surgery ( T₅ ) and extubation ( T₆ ) monitoring in patients with left ventricular output ( CO ), each Bo output ( SV ), peripheral vascular resistance ( SVR ), peak velocity ( Vpk ), percentage of net ejection time ( ET ) and heart rate (HR ) condition.Results Part one : compared with the situation in T₀ , MAP and SVR of group S and group M were declined obviously (P <0.05);CO,SV,Vpk, MAP and SVR of group P were decreased significantly (P <0.05, P <0.01)and ET was prolonged (P <0.05). Compared with group S and group M, MAP and SVR of group P were declined obviously in T₁,T₂,T₃,T₄(P <0.05); compared with group M, SVR of group S was down significantly in T₁, T₂, T₃, T₄ (P <0.05).Part two : Compared with T₀, CO,SV,Vpk,SVR and HR of control group T₁ was significantly lower, and the difference had statistical significance (P < 0.05). Compared with T₀, groupâ… , groupâ…¡and groupâ…¢T₁,T₂,T₆ , CO,SV,SVR, Vpk and ET was lower significantly, the difference had statistical significance(P<0.05).Compared between control group, groupâ… , groupâ…¡and groupâ…¢each other T₀,T₁,T₂,T₃,T₄,T₅,T₆; CO,SV, SVR, Vpk and ET are significantly changed , and it had statistical significance(P< 0.05).Conclusionâ‘ Three kinds of general anesthetics could be inducted safely and effectivly on American Anesthesiologist Association( ASA)Ⅰ～Ⅱelderly patients, but the inhibition on the cardiac function of elderly patients is the biggest with propofol, and the smallest with midazolam in three groups.â‘¡The cardiac function of elderly patients with hypertensive had a significantly changes during perioperative period, the higher the risk level is, the more apparent the cardiac change is , the higher the risk is.