Background: Ramosetron is a relatively new 5-hydroxytryptamine three receptor antagonist with higher binding\naffinity and more prolonged duration of action compared to ondansetron. The present study was performed to\nevaluate the effects of ramosetron on QTc interval and possible cardiovascular adverse effects in patients\nundergoing cardiac surgery.\nMethod: A total of 114 patients who underwent off-pump coronary artery bypass surgery were enrolled in this\nrandomised placebo-controlled trial. Patients were allocated into two groups that received intravenous injection of\n0.3 mg ramosetron or normal saline during induction of anaesthesia. QTc intervals were measured before the\noperation, intraoperatively (0, 1, 2, 3, 5, 10, 15, 30, 45, 60, 90, 120, and 240 min after injection of ramosetron or\nnormal saline), at the end of the operation, and on postoperative day 1.\nResults: There were no differences in mean QTc interval between groups at every time point. However, maximal change\nin QTc interval during surgery was higher in the ramosetron group than the placebo group (25.1 Ã?± 22.0 vs. 17.5 Ã?± 14.5 ms,\n95 % CI 0.34ââ?¬â??14.78, P = 0.040). Also, there were more patients with a QTc interval increase of > 60 ms in the ramosetron\ngroup (5 vs. 0, 95 % CI 1.6ââ?¬â??18.0, P = 0.021). There were no significant differences in cardiovascular complications.\nConclusions: Ramosetron administered during induction of anaesthesia may affect maximal change in QTc interval\nduring off-pump coronary artery bypass surgery. Ramosetron should be used with caution in high risk patients for\ndeveloping Torsades de Pointes.
Loading....