Comparison between dexmedetomidine and propofol on outcomes after coronary artery bypass graft surgery: a retrospective study

BMC Anesthesiology

Bingfeng Lv¹  Jie Hu¹  Xingpeng Chen²  Daqing Ma³  Raha West³  Chen Pac Soo⁴  Yali Yan⁵ 

[1] Department of Anesthesiology, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan, China;Department of cardiovascular surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan, China;Division of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, UK;Division of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, UK;Department of Anesthesiology, Wycombe General Hospital, Queen Alexandra Road, HP11 2TT, High Wycombe, Buckinghamshire, UK;Information Center, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan, China;

关键词: Dexmedetomidine;    Propofol;    CABG;    Pulmonary complications;    Surgical time;   

DOI  :  10.1186/s12871-022-01589-6

来源: Springer

【 摘 要 】

BackgroundDexmedetomidine (DEX) has a pharmacological profile that should allow rapid recovery and prevent undesirable outcomes such as pulmonary complications.MethodsThis large retrospective study compared the beneficial effects of perioperative infusion of DEX with propofol on the postoperative outcome after coronary artery bypass graft surgery. We reviewed patients’ medical notes at Luoyang Central Hospital from 1st January 2012 to 31st December 2019. All continuous variables, if normally distributed, were presented as mean ± SD; Otherwise, the non-normally distributed data and categorical data were presented as median (25-75 IQR) or number (percentage). The Mann-Whitney U test and Chi-square test were used to evaluate the difference of variables between the DEX and propofol groups. Multivariate logistic regression analysis was performed on the main related and differential factors in the perioperative period.ResultsA total of 1388 patients were included in the study; of those, 557 patients received propofol infusion, and 831 patients received dexmedetomidine. DEX significantly reduced postoperative pulmonary complications compared with propofol, 7.82% vs 13.29%; P < 0.01, respectively. When compared with propofol, DEX significantly shortened the duration of mechanical lung ventilation, 18 (13,25) hours vs 21 (16,37) hours; P < 0.001, the length of stay in the intensive care unit, 51 (42,90) vs 59 (46,94.5) hours; P = 0.001 and hospital stay, 20 (17,24) vs 22 (17,28) days; P < 0.001, respectively. The incidences of postoperative wound dehiscence and infection were significantly reduced with DEX compared with propofol groups, 2.53% vs 6.64%; P < 0.001, respectively. Interestingly, patients receiving DEX had significantly shorter surgical time compared to propofol; 275 (240,310) vs 280 (250,320) minutes respectively (P = 0.005) and less estimated blood loss (P = 0.001).ConclusionPerioperative infusion of dexmedetomidine improved the desirable outcomes in patients who had coronary artery bypass graft surgery compared with propofol.

【 授权许可】

CC BY