Cardiovascular effects of ketanserin in the treatment of hypertension during coronary artery bypass surgery.

The cardiovascular effects of ketanserin (5-HT2-receptor antagonist with alpha 1-receptor blocking property) were studied during coronary artery surgery. Sixteen patients were anesthetized with flunitrazepamfentanyl-nitrous oxide-oxygen-pancuronium. Ketanserin (10 mg i.v.) was used to decrease elevated blood pressure unresponsive to deepening of anesthesia before extracorporeal circulation. Ketanserin caused a marked vasodilation in all patients, significant (p less than 0.05) decreases of systolic, diastolic, and mean arterial blood pressure, and of pulmonary artery pressure and pulmonary capillary wedge pressure. As a result, indirect indices of myocardial oxygen demand (rate-pressure product and "triple index") also decreased. Heart rate and right atrial pressure remained unchanged, while cardiac index and stroke volume index increased slightly. Ketanserin was found to be effective in the treatment of prebypass hypertension; the elevated blood pressure returned to normal; unwanted hypotension was not observed.