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 soun ds has never been quantified. We determined the root mean squared amplitude and frequency characteristics (peak frequency, spectral edge, and power ra tios) 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 (R-2 = 0.87 +/- 0.12) and S2 (R-2 = 0.66 +/- 0.33) and the high-frequency components (>80 Hz) of these sounds. These cha nges were clearly audible and preceded decreases in heart rate and blood pr essure. The spectral edge decreased for S1 in 18 patients (R-2 = 0.73 +/- 0 .24) and for S2 in 13 patients (R-2 = 0.58 +/- 0.25). Peak frequency did no t change. The rapidity with which myocardial depression and its associated changes in heart sound characteristics occurred confirms that continuous au scultation of heart sounds is a useful clinical tool for hemodynamic monito ring of anesthetized infants and children. Implications: Heart sound charac teristics can be used to monitor cardiac function during halothane anesthes ia in children The changes occur rapidly and precede noticeable changes in heart rate and blood pressure.