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. 2025 Jun 27:18:3463-3476.
doi: 10.2147/IJGM.S524691. eCollection 2025.

Effects of Dexmedetomidine or Propofol on Postoperative Oxygenation Index During Invasive Ventilation in Patients After off-Pump Coronary Artery Bypass Grafting: a Single-Center Retrospective Study

Fang Li  1 , Luwei Ma  1 , Suhua Yan  2 , Dongyi Liu  3
Affiliations

Effects of Dexmedetomidine or Propofol on Postoperative Oxygenation Index During Invasive Ventilation in Patients After off-Pump Coronary Artery Bypass Grafting: a Single-Center Retrospective Study

Fang Li et al. Int J Gen Med. .

Abstract

Purpose: This study aimed to compare the effects of dexmedetomidine (DEX) and propofol on patients undergoing invasive ventilation after off-pump coronary artery bypass grafting (OPCABG) with regard to oxygenation index (OI) (PaO2/FiO2), hemodynamic changes, extubation time, and adverse reactions.

Patients and methods: This single-center retrospective study included 195 patients admitted to the cardiovascular surgery intensive care unit (CVICU) after OPCABG between January 2022 and June 2024. According to the postoperative invasive mechanical ventilation for sedation with only DEX or propofol, the patients were classified into groups D and P. The primary outcome was oxygenation index (OI) before and after extubation. The secondary outcomes included mean arterial pressure (MAP) and heart rate (HR) before and after extubation, extubation time, and adverse reactions after surgery.

Results: DEX was significantly associated with an increased likelihood of OI before and after extubation composed to propofol (P < 0.05). MAP and HR after extubation were significantly higher than before extubation in Group P (P < 0.05). However, there were no significant differences between before and after extubation in Group D (P < 0.05). Furthermore, MAP and HR were significantly lower in Group D than in Group P before and after extubation (P < 0.05). In addition, the extubation time was significantly shorter in Group D in comparison of propofol (P < 0.05). Additionally, the incidence of delirium and severe cough at extubation after surgery was significantly lower in Group D than in Group P (P < 0.05).

Conclusion: DEX may support satisfactory OI, good hemodynamic stability, rapid extubation time, and a lower incidence of adverse reactions for sedation of mechanically ventilated patients following OPCABG surgery compared to propofol, although the difference with OI did not reach the MCID.

Keywords: dexmedetomidine; invasive ventilation; off-pump coronary artery bypass grafting; oxygenation index; propofol.

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Conflict of interest statement

The authors state no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow chart of patient screening and selection process.Group D, postoperative mechanical ventilation using only DEX for sedation; Group P, postoperative mechanical ventilation using only propofol for sedation.
Figure 2
Figure 2
OI (PaO2/FiO2) before and after surgery between groups. OI was significantly higher in Group D compared with Group P before and after extubation (P<0.05). However, there was no statistically significant difference in terms of OI before and after surgery between groups (P>0.05), respectively. The data are given as mean ± SD, and were compared by independent-sample t-test. Group D, postoperative mechanical ventilation using only DEX for sedation; Group P, postoperative mechanical ventilation using only propofol for sedation.
Figure 3
Figure 3
MAP before and after extubation between groups (A) HR before and after extubation between groups (B) MAP and HR after extubation were significantly higher than before extubation in Group P (#P < 0.05), respectively. However, there was no significant difference between before and after extubation with regard to the MAP and HR in Group D (P > 0.05). Furthermore, MAP and HR were significantly lower in Group D compared with Group P before and after extubation (*P < 0.05), respectively. There was no statistically significant difference in terms of MAP and HR before and after surgery between groups (P > 0.05), respectively. The data are given as mean ± SD. Data were compared by independent-sample t-test. Compared with Group P, *P<0.05, compared with before extubation, #P<0.05. Group D, postoperative mechanical ventilation using only DEX for sedation; Group P, postoperative mechanical ventilation using only propofol for sedation.
Figure 4
Figure 4
Comparison of the extubation time between groups. The data are given as mean ± SD, and were compared by independent-sample t-test. The extubation time was remarkably shorter in Group D in comparison of propofol (P < 0.001). Group D, postoperative mechanical ventilation using only DEX for sedation; Group P, postoperative mechanical ventilation using only propofol for sedation.
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