Freeman A B, Steinbrook R A
Can Anaesth Soc J. 1985 Nov;32(6):654-7. doi: 10.1007/BF03011415.
Following aortic valve replacement in a patient with aortic stenosis and cardiac failure, marked pulsus alternans recurred immediately after intravenous injection of 0.5 mg fentanyl, without concomitant changes in heart rate, mean left atrial pressure, or the electrocardiogram. Pulsus alternans is known to occur in association with heart failure and aortic stenosis, but has not been reported previously in response to anaesthetic drugs. Mechanisms of pulsus alternans are discussed, and the possible contributory role of fentanyl is considered.
在一名患有主动脉瓣狭窄和心力衰竭的患者进行主动脉瓣置换术后，静脉注射0.5毫克芬太尼后立即再次出现明显的交替脉，同时心率、平均左心房压力或心电图均无相应变化。已知交替脉与心力衰竭和主动脉瓣狭窄有关，但此前尚未有因麻醉药物而出现交替脉的报道。本文讨论了交替脉的机制，并考虑了芬太尼可能起的作用。
