The effect of halothane on the amplitude and frequency characteristics of heart sounds in children.
Although continuous auscultation has been used during surgery as a monitor of cardiac function for many years, the effect of anesthetics on heart sounds has never been quantified. We determined the root mean squared amplitude and frequency characteristics (peak frequency, spectral edge, and power ratios) of the first (S1) and second (S2) heart sounds in 19 healthy children during induction of anesthesia with halothane. In all patients, halothane decreased the amplitude of S1 (R2 = 0.87 +/- 0.12) and S2 (R2 = 0.66 +/- 0.33) and the high-frequency components (>80 Hz) of these sounds. These changes were clearly audible and preceded decreases in heart rate and blood pressure. The spectral edge decreased for S1 in 18 patients (R2 = 0.73 +/- 0.24) and for S2 in 13 patients (R2 = 0.58 +/- 0.25). Peak frequency did not change. The rapidity with which myocardial depression and its associated changes in heart sound characteristics occurred confirms that continuous auscultation of heart sounds is a useful clinical tool for hemodynamic monitoring of anesthetized infants and children.


CONCLUSIONS
Heart sound characteristics can be used to monitor cardiac function during halothane anesthesia in children. The changes occur rapidly and precede noticeable changes in heart rate and blood pressure.
Manecke
G R
GR
Department of Anesthesiology, University Medical Center, State University of New York at Stony Brook, 11794-8480, USA.
Nemirov
M A
MA
Bicker
A A
AA
Adsumelli
R N
RN
Poppers
P J
PJ
D000367:Age Factors; D018685:Anesthetics, Inhalation / Q000008:administration & dosage / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D006221:Halothane / Q000008:administration & dosage / Q000494:pharmacology*; D006321:Heart / Q000187:drug effects; D006326:Heart Auscultation; D006339:Heart Rate / Q000187:drug effects; D006347:Heart Sounds / Q000187:drug effects*; D006801:Humans; D007223:Infant; D016343:Monitoring, Intraoperative; D013018:Sound Spectrography