Volume 29, Issue 2 (5-2026)
J Arak Uni Med Sci 2026, 29(2): 173-181 |
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Rafiei T, Kamali A R, Hachemi P, Rafiei M, Modir H. : Propofol vs. Dexmedetomidine: Effects on Extubation Time and Length of Stay in ICU/ Hospital After Cardiac Surgery. J Arak Uni Med Sci 2026; 29 (2) :173-181
URL: http://jams.arakmu.ac.ir/article-1-8085-en.html
URL: http://jams.arakmu.ac.ir/article-1-8085-en.html
1- Medical Student of Arak University of Medical Sciences, Arak, Iran
2- Professor, Department of Anesthesiology, Arak University of Medical Sciences, Arak, Iran ,alikamaliir@yahoo.com
3- Assitant Professor, Department of Cardiology, Arak University of Medical sciences, Arak, Iran
4- Professor, Department of Biostatistics, Arak University of Medical Sciences, Arak, Iran
5- Professor, Department of Anesthesiology, Arak University of Medical Sciences, Arak, Iran
2- Professor, Department of Anesthesiology, Arak University of Medical Sciences, Arak, Iran ,
3- Assitant Professor, Department of Cardiology, Arak University of Medical sciences, Arak, Iran
4- Professor, Department of Biostatistics, Arak University of Medical Sciences, Arak, Iran
5- Professor, Department of Anesthesiology, Arak University of Medical Sciences, Arak, Iran
Abstract: (107 Views)
Introduction: As a complex medical intervention, open-heart surgery induces significant physiological alterations, necessitating rigorous pharmacological management in the postoperative phase, especially within the ICU setting. A critical challenge in this patient population involves achieving prompt extubation and hemodynamic stability following cessation of anesthetic drugs. Propofol and dexmedetomidine – commonly employed sedatives during this phase – exhibit distinct pharmacological profiles with comparative benefits and limitations. This investigation was designed to evaluate and contrast the effects of these agents on extubation latency, sedation efficacy, ICU hospitalization duration, and overall hospital stay across both treatment cohort.
Methods: This randomized controlled trial enrolled 92 eligible CABG patients. Using block randomization, participants were assigned to dexmedetomidine or propofol cohorts, with age and sex matching between groups. Primary outcomes comprised Ramsay Sedation Scale assessments, extubation timing following ICU transfer, ICU and hospital lengths of stay, plus mortality/discharge status. Statistical analyses employed R software (version X.X) utilizing comparative intergroup mean tests.
Results: Both cohorts demonstrated age and sex homogeneity. The mean Ramsay Sedation Scale score was significantly lower in the dexmedetomidine group compared to the propofol group (P <0.01). Similarly, post-ICU admission extubation time was significantly reduced in dexmedetomidine recipients versus propofol-treated patients (P< 0.001). No statistically significant difference in mortality distribution was observed between treatment groups (P = 0.45).
Conclusions: This investigation revealed that dexmedetomidine offered significant clinical advantages over propofol in patients undergoing open-heart surgery, demonstrating lower Ramsay Sedation Scale scores (P < 0.01) and significantly reduced extubation times (P < 0.001). These outcomes suggest potential reductions in ICU occupancy and superior recovery profiles. Given its association with expedited extubation, dexmedetomidine represents a viable sedation alternative in post-cardiac surgical care. These findings provide evidence to guide evidence-based sedative selection in cardiac surgery intensive care. Nevertheless, multicenter trials with expanded cohorts are warranted to validate these observations and examine longitudinal clinical trajectories.
Methods: This randomized controlled trial enrolled 92 eligible CABG patients. Using block randomization, participants were assigned to dexmedetomidine or propofol cohorts, with age and sex matching between groups. Primary outcomes comprised Ramsay Sedation Scale assessments, extubation timing following ICU transfer, ICU and hospital lengths of stay, plus mortality/discharge status. Statistical analyses employed R software (version X.X) utilizing comparative intergroup mean tests.
Results: Both cohorts demonstrated age and sex homogeneity. The mean Ramsay Sedation Scale score was significantly lower in the dexmedetomidine group compared to the propofol group (P <0.01). Similarly, post-ICU admission extubation time was significantly reduced in dexmedetomidine recipients versus propofol-treated patients (P< 0.001). No statistically significant difference in mortality distribution was observed between treatment groups (P = 0.45).
Conclusions: This investigation revealed that dexmedetomidine offered significant clinical advantages over propofol in patients undergoing open-heart surgery, demonstrating lower Ramsay Sedation Scale scores (P < 0.01) and significantly reduced extubation times (P < 0.001). These outcomes suggest potential reductions in ICU occupancy and superior recovery profiles. Given its association with expedited extubation, dexmedetomidine represents a viable sedation alternative in post-cardiac surgical care. These findings provide evidence to guide evidence-based sedative selection in cardiac surgery intensive care. Nevertheless, multicenter trials with expanded cohorts are warranted to validate these observations and examine longitudinal clinical trajectories.
Keywords: Dexmedetomidine, Propofol, Extubation, ICU Length of Stay, Hospital Length of Stay, Mortality
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