title: The use of the 5-HT3-receptor antagonist ondansetron for the treatment of postcardiotomy delirium.
abstract: OBJECTIVE
  To evaluate the effect of the 5-HT3-receptor antagonist ondansetron in patients with postcardiotomy delirium.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Thirty-five patients who had undergone coronary artery bypass graft surgery.
  
  
  METHODS
  Thirty-five patients, 23 men and 12 women, who developed delirium in the intensive care unit after coronary artery bypass graft surgery were included. Mean patient age was 51.3 years (range, 36 to 79 years). A mental status scoring scale was developed, and patients were scored 0 to 4 according to their delirium status after confirming that there were no correctable metabolic abnormalities as an underlying cause for delirium. Normal behavior was scored as 0, and severe verbal and physical agitation was scored as 4. Patients received a single dose of ondansetron, 8 mg, intravenously and were reevaluated 10 minutes later.
  
  
  RESULTS
  Before the treatment, 7 patients had a score of 2 (20%); 10 patients (28.6%), 3; and 18 patients (51.4%), 4. After the treatment, 28 patients (80%) dropped their score to 0; 6 patients (17.1%) dropped to a score of 1, and 1 patient (2.9%) remained at a score of 4. The mean score dropped from 3.20 + 1.01 to 0.29 + 0.75 after treatment. Wilcoxon signed ranks test was used for statistical evaluation, and the fall in delirium score after ondansetron treatment was found to be statistically significant (p < 0.001).
  
  
  CONCLUSIONS
  The use of ondansetron was effective and safe and without important side effects. This positive effect of the 5-HT3-receptor antagonist ondansetron led to speculation that impaired serotonin metabolism may play a role in postcardiotomy delirium.
authors.affiliation: Department of Anesthesia, Kadir Has University Medical Faculty, Florence Nightingale Hospital, Sişli-Istanbul, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Bayindir
authors.forename: B
authors.initials: B
authors.lastname: Akpinar
authors.forename: E
authors.initials: E
authors.lastname: Can
authors.forename: M
authors.initials: M
authors.lastname: Güden
authors.forename: B
authors.initials: B
authors.lastname: Sönmez
authors.forename: C
authors.initials: C
authors.lastname: Demiroğlu
mesh_terms: D000328:Adult; D000368:Aged; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003693:Delirium / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017294:Ondansetron / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy*; D011446:Prospective Studies; D011985:Receptors, Serotonin / Q000502:physiology; D044406:Receptors, Serotonin, 5-HT3; D012702:Serotonin Antagonists / Q000627:therapeutic use*
chemical_list: D011985:Receptors, Serotonin; D044406:Receptors, Serotonin, 5-HT3; D012702:Serotonin Antagonists; D017294:Ondansetron