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We have studied the effect of ketanserin, a selective serotonin S2-receptor antagonist, on surgical bleeding in a double-blind, placebo-controlled study in elderly patients undergoing total hip arthroplasty. One group of patients (n = 9) received ketanserin 10 mg i.v. followed by an infusion of 0.075 mg kg-1 h-1. The second group (n = 8) received placebo. Both groups were comparable with regard to age, height and body weight. Mean intraoperative blood loss was 454 ml with ketanserin and 894 ml with placebo (P = 0.004; Wilcoxon two-sample test). Mean duration of the operation was less with ketanserin (112 min) than with placebo (134 min) (P = 0.004), but rate of blood loss was also less with ketanserin (4.1 vs 6.7 ml min-1; P = 0.03). In the ketanserin group, mean arterial pressures tended to be less than in the placebo group. Reductions in central venous pressure were similar in both groups. There were no complications in relation to the use of ketanserin.

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