The effect of perioperative use of dexmedetomidine on time to extubation and ICU stay after coronary artery bypass graft surgery: a single-center retrospective cohort study

Abstract

Background: Dexmedetomidine plays an important role in postoperative respiratory weaning after cardiac surgery due to its sedative and analgesic properties without causing respiratory depression.

Objectives: To evaluate if dexmedetomidine could shorten postoperative ventilation time, ICU stay (primary outcomes) and total hospital stay (secondary outcome).

Methods: All patients who underwent elective CABG surgery between January 1st 2019 and March 3rd 2021 in AZ Sint-Jan, Bruges, Belgium were included in this retrospective single-center study. 175 of them received dexmedetomidine perioperative, opposed to 248 patients who did not.

Results: When looking at the postoperative length of ICU stay, no significant difference could be detected between the dexmedetomidine and non-dexmedetomidine group (median of 2 days, CI95% [2 - 3] vs 2 days CI95% [2-3] respectively; p= 0,5462). No difference in postoperative hospital stay could be detected between the dexmedetomidine and non-dexmedetomidine group either (median of 7 days, CI95% [7 - 8] vs 7 days, CI95% [7 - 7] respectively; p=0,4731). Time to extubation was significantly lower in the group with perioperative dexmedetomidine administration in comparison to those who did not receive dexmedetomidine during surgery (mean of 375 minutes; CI95% [332 - 418] vs 487 minutes; CI95% [420 - 555] respectively; p=0,0059).

Conclusion: Dexmedetomidine can play an important role in postoperative respiratory weaning after elective CABG surgery by reducing the postoperative mechanical ventilation time. No effect on ICU stay and total length of hospital stay could be detected.