Abstract
The haemodynamic effects of ketanserin were studied consecutively in seventeen patients in the intensive care unit following coronary artery bypass grafting. Hypertensive patients (Group 1, systolic blood pressure (SBP) ≥ 150 mmHg following discontinuation of nitroprusside, n = 10) received intravenous ketanserin 10 mg and infusion of 0.1 mg.kg−1.hr−1 with additional boluses as required to maintain SBP ≤ 130 mmHg for one hour. Non-hypertensive patients (Group 2, SBP < 150 mmHg, n = 7) received a 5 mg bolus and the same infusion. Ketanserin significantly decreased arterial blood pressure (P < 0.001) in all patients in Group 1. Heart rate was decreased but not significantly. Cardiac index, systemic and pulmonary vascular resistance and pulmonary shunt fraction were not significantly altered from pre-ketanserin values when blood pressure was controlled with nitroprusside. Normotensive patients in Group 2 did not show any undesirable hypotension or significant haemodynamic changes. Mean nitroprusside dose requirements following ketanserin therapy were significantly reduced by 91.6% in Group 1 and 78.4% in Group 2 (P < 0.05). Ketanserin is effective in treating hypertension following coronary artery bypass grafting with an advantage of lack of reflex tachycardia.