Dexmedetomidine versus propofol for postoperative recovery after cardiac surgery: a historical cohort study

The impact of postoperative dexmedetomidine sedation on outcomes following cardiac surgery remains controversial. We sought to compare postoperative sedation techniques with dexmedetomidine vs propofol infusions on postoperative recovery outcomes following cardiac surgery to assess whether dexmedetomidine is associated with longer time to achieve recovery milestones.

In this historical cohort study, we abstracted the electronic medical records of a convenience sample of cardiac surgery patients either receiving dexmedetomidine (0.5-1.5 µg·kg^-1·hr^-1) or propofol (5-80 µg·kg^-1·min^-1) infusions for postoperative sedation. The study period included time periods where the standard postoperative sedation practice included dexmedetomidine (March 2019-January 2022) or propofol (January 2022-June 2022) infusions. Measured outcomes for both groups included time to tracheal extubation and intensive care unit and hospital length of stay.

Two thousand and sixty-five patients receiving dexmedetomidine and 510 patients receiving propofol were included. Postoperative sedation after cardiac surgery with dexmedetomidine was associated with a 1.8-hr longer time to tracheal extubation than propofol (98.3% confidence interval, 1.5 to 2.1; P < 0.001).

Dexmedetomidine administration for postoperative sedation in a convenience sample of over 2,000 cardiac surgery patients was associated with a longer time to tracheal extubation than propofol.