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Effect of ramosetron on QTc interval: a randomised controlled trial in patients undergoing off-pump coronary artery bypass surgery

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Authors
Kim, Tae Kyong; Cho, Youn Joung; Lim, Chae-won; Min, Jeong Jin; Choi, Eue-Keun; Hong, Deok Man; Jeon, Yunseok
Issue Date
2016-08-03
Publisher
BioMed Central
Citation
BMC Anesthesiology, 16(1):56
Keywords
Cardiac surgeryCorrected QT intervalRamosetronTorsadogenic actionSerotonin 5-HT3 receptor antagonists
Description
This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made.
Abstract
Abstract

Background
Ramosetron is a relatively new 5-hydroxytryptamine three receptor antagonist with higher binding affinity and more prolonged duration of action compared to ondansetron. The present study was performed to evaluate the effects of ramosetron on QTc interval and possible cardiovascular adverse effects in patients undergoing cardiac surgery.


Method
A total of 114 patients who underwent off-pump coronary artery bypass surgery were enrolled in this randomised placebo-controlled trial. Patients were allocated into two groups that received intravenous injection of 0.3 mg ramosetron or normal saline during induction of anaesthesia. QTc intervals were measured before the operation, intraoperatively (0, 1, 2, 3, 5, 10, 15, 30, 45, 60, 90, 120, and 240 min after injection of ramosetron or normal saline), at the end of the operation, and on postoperative day 1.


Results
There were no differences in mean QTc interval between groups at every time point. However, maximal change in QTc interval during surgery was higher in the ramosetron group than the placebo group (25.1 ± 22.0 vs. 17.5 ± 14.5 ms, 95 % CI 0.34–14.78, P = 0.040). Also, there were more patients with a QTc interval increase of > 60 ms in the ramosetron group (5 vs. 0, 95 % CI 1.6–18.0, P = 0.021). There were no significant differences in cardiovascular complications.


Conclusions
Ramosetron administered during induction of anaesthesia may affect maximal change in QTc interval during off-pump coronary artery bypass surgery. Ramosetron should be used with caution in high risk patients for developing Torsades de Pointes.


Trial registration
ClinicalTrials.gov NCT02139241. Registered November 12, 2013
Language
English
URI
https://hdl.handle.net/10371/100434
DOI
https://doi.org/10.1186/s12871-016-0222-1
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College of Medicine/School of Medicine (의과대학/대학원)Anesthesiology and Pain Medicine (마취통증의학전공)Journal Papers (저널논문_마취통증의학전공)
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