Dexmedetomidine vs. propofol sedation reduces the duration of mechanical ventilation after cardiac surgery – a randomized controlled trial

M. Preveden, R. Zdravković, S. Vicković, V. Vujić, M. Todić, N. Mladenović, N. Dračina, V. Drljević Todić, T. Pantić, B. Okiljević, N. Marković, A. Kovač, R. Zec, A. Preveden, M. Tatić

Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia. andrej.preveden@mf.uns.ac.rs

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• Cardiology
• Surgery

OBJECTIVE: The aim of our study was to compare the clinical effects of sedation with dexmedetomidine vs. propofol in patients undergoing cardiac surgery and analyze their effects on the duration of mechanical ventilation (MV), length of stay in the intensive care unit (ICU), and total hospital stay.

PATIENTS AND METHODS: The study included 120 patients who were randomized in a 1:1 ratio into two groups of 60 patients. The first group was sedated with continuous dexmedetomidine in doses 0.2-0.7 mcg/kg/h. The second group was sedated with propofol in doses 1-2 mg/kg/h.

RESULTS: Patients sedated with dexmedetomidine required 2.2 hours less time on MV (p<0.001). There was a positive correlation between the duration of MV and the ICU length of stay (r=0.368; p<0.001), as well as between the duration of MV and the total hospital stay (r=0.204; p=0.025). Delirium occurred in the postoperative period in 25% of patients sedated with propofol, while in the dexmedetomidine group it was only 11.7% (p=0.059). Patients who developed delirium had a significantly longer duration of MV (12.6±5.4 vs. 9.3±2.5 hours, p=0.010).

CONCLUSIONS: Postoperative sedation with dexmedetomidine, compared to propofol, reduces the duration of MV, but does not influence the length of stay in the ICU and length of hospitalization after open heart surgery.

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