Evaluation Of Left Ventricular Function During Anesthesia Induction In Elderly Patients By Bedside Transthoracic Echocardiography

Objective: Using portable bedside echocardiography to observe the changes of left ventricular function in elderly patients undergoing non cardiac surgery during induction of anesthesia,so as to provide reference for anesthesia,in order to improve the safety of anesthesia in elderly patients.Method: From March 2017 to December 2017,40 patients in our hospital undergoing non-cardiac surgery,including 22 cases of male,female18 cases,age 60~75 years,The Association of American standard(ASA)I-II,Body mass index(BMI)18.5-23.9kg.m-2,without serious heart and lung diseases,by Intravenous Inhalation anesthesia.Using portable bedside ultrasound diagnosis for patients' left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),Early diastolic velocities of mitral annulus(Ea),Late diastolic velocities of mitral annulus(Aa),Peak systolic velocities of mitral annulus(Sa),mitral annulus velocity ratio(Ea/Aa)with basic value before anesthesia(T0),1 min before intubation(T1),immediately after intubation(T2),3 min after intubation(T3).And calculate the output stroke volume(SV),left ventricular ejection fraction(EF),Tei index of T0,T1,T2 and T3.A multifunctional anesthesia monitor was used to monitor the record of non-invasive arterial systolic blood pressure(SP),diastolic blood pressure(DP)and heart rate(HR).SPSS 22.0 statistical software was used for analysis,and The measurement data is expressed as(x±s).The variance analysis of repeated measures was used in the group,and P<0.05 was considered statistically significant.In this study,P values were both double-tailed and P <0.05 was considered to be statistically significant.Result: Compared with T0,the EF,CO,Sa,Ea,Aa,Ea/Aa of T1 and T2 were all decreased,P<0.05;Tei index increased,P<0.05;However,the EF,CO,Sa,Ea,Aa,Ea/Aa of T3 were decreased,but there was no statistical difference,P>0.05,Tei index increased,and there was no difference in statistics,P >0.05.Conclusion: 1.Compared with T0,the left cardiac function in the initial stage of anesthesia induction(T1 and T2)decreased significantly,while the left cardiac function was restored to a certain degree after 3min(T3)after intubation.2.Bedside echocardiography in anesthesia induction period repeated detection of different time,can effectively monitor anesthesia induced inhibition of cardiac function and heart function change,is a kind of simple and noninvasive,fast and effective monitoring means.