optimal site for precordial stethoscope placement in pediatric patients younger than two years: a preliminary cross-sectional study

Background: the precordial stethoscope is a traditional and non-invasive monitoring method during pediatric general anesthesia. in this preliminary cross-sectional study, we aimed to investigate the characteristics of lung and heart sounds via precordial stethoscope and determine the optimal site for auscultation in children below 2 years of age. methods: this study involved 68 patients who underwent general anesthesia with tracheal intubation. auscultation sounds via precordial stethoscope were recorded in mp3 format at the following three sites: site a-region between the clavicle and nipple on the left midclavicular line; site b-region between the nipple and costal arch on the left midclavicular line; and site c-point on the left midaxillary line that was horizontally leveled with site b. eight blinded evaluators individually and randomly scored lung and heart sounds on a 10-point scale (0: cannot hear at all and 10: can hear clearly). results: lung sound scores at sites a, b, and c were 8.0 (7.0–9.0), 4.5 (2.9–6.0), and 7.0 (5.5–8.5), respectively, while heart sound scores at sites a, b, and c were 3.5 (2.0–6.0), 6.5 (4.0–8.0), and 1.0 (0.4–2.0), respectively. statistically significant differences were found in all pairs of sites. conclusion: we suggest that site a, where anesthesiologists can hear both the lung and heart sounds, is the optimal site of precordial stethoscope attachment during general anesthesia for intubated children below 2 years of age.