title: Effect of ramosetron on QTc interval: a randomised controlled trial in patients undergoing off-pump coronary artery bypass surgery.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  ClinicalTrials.gov NCT02139241. Registered November 12, 2013.
authors.affiliation: Department of Anaesthesiology and Pain medicine, Seoul National University Hospital, Daehakro 101, Jongno-gu, Seoul, 110-744, Korea.
authors.forename: Tae Kyong
authors.initials: TK
authors.lastname: Kim
authors.affiliation: Department of Anaesthesiology and Pain medicine, Seoul National University Hospital, Daehakro 101, Jongno-gu, Seoul, 110-744, Korea.
authors.forename: Youn Joung
authors.initials: YJ
authors.lastname: Cho
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Cheorwon Gil Hospital, Gangwon-Do, Korea.
authors.forename: Chae-Won
authors.initials: CW
authors.lastname: Lim
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre, Seoul, Korea.
authors.forename: Jeong Jin
authors.initials: JJ
authors.lastname: Min
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Eue-Keun
authors.initials: EK
authors.lastname: Choi
authors.affiliation: Department of Anaesthesiology and Pain medicine, Seoul National University Hospital, Daehakro 101, Jongno-gu, Seoul, 110-744, Korea.
authors.forename: Deok Man
authors.initials: DM
authors.lastname: Hong
authors.affiliation: Department of Anaesthesiology and Pain medicine, Seoul National University Hospital, Daehakro 101, Jongno-gu, Seoul, 110-744, Korea. jeonyunseok@gmail.com.
authors.forename: Yunseok
authors.initials: Y
authors.lastname: Jeon
mesh_terms: D000368:Aged; D000932:Antiemetics / Q000008:administration & dosage / Q000009:adverse effects; D001562:Benzimidazoles / Q000008:administration & dosage* / Q000009:adverse effects; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D004311:Double-Blind Method; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012702:Serotonin Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors
chemical_list: D000932:Antiemetics; D001562:Benzimidazoles; D012702:Serotonin Antagonists; C071315:ramosetron
keywords: Cardiac surgery; Corrected QT interval; Ramosetron; Serotonin 5-HT3 receptor antagonists; Torsadogenic action