The Perianesthesia Of Heart Reserve Based On Heart Sound Monitoring

Entire venous anesthesia can have acutely pharmacological, physiological effect on patients'cardiac status during anesthesia duration and intubation duration and patients would be in danger if their cardiac function were weak. So to measure and evaluate the cardiac reserve is necessarily. Cardiac reserve evaluation can give doctor and patients more details about various diseases and cardiac condition after stress reaction. At present, in clinic, electrocardiogram monitor and anesthesia monitor are devoid of cardiac reserve monitoring; float catheter is invasive in cardiac reserve monitoring; ultrasonogram is inexpedient and the sensitivity of some indexes is weak. Thus, study the noninvasive and portable method for monitoring cardiac patients during anesthesia and intubation, especially quantitative monitoring and analysis is necessary.Being as an noninvasive, portable method, phonocardiogram was used in this study, and 103 ASA physical statusⅠa ndⅡpatients aged 16 yr to 80 yr presenting for urologic surgery participated in the test. Objective of this investigation is to further analyze the cardiac function status change by phonocardiogram under the effect of mixed anesthesia which is conducted by midazolam, skelaxin, fentanyi and propofol. By FIR and wavelet methods, it is found statistically that after mixed anesthesia took effect, first heart sound (S1), second heart sound (S2), blood pressure and heart rate fell, cardiac reserve deceased, compared with baseline duration; during endotracheal intubation, S1, S2, blood pressure and heart rate risen, cardiac reserve increased, compared with anesthesia duration. Usually, cardiac reserve will decrease at anesthesia duration compared with baseline, and cardiac reserve will increase at intubation duration compared with baseline, but never higher than baseline. This can help doctor makes accurate decision for patients. Simultaneously, our study demonstrates that phonocardiogram as a noninvasive, high benefit/cost ratio, objective, repeatable and portable method can be used for the monitoring and evaluation of cardiac function status during anesthesia and operations.