Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 0 0 2026 08 01 1626 1626 Maryam Baniani Anesthesiology Research Center, Department of Anesthesiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Ali Dabbagh Anesthesiology Research Center, Department of Anesthesiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Arezou Ashari Department of Community Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Manar Baqer Shamkhi Al-Juaifari Clinical Research and Development Unit, Imam Hossein Hospital, Department of Anesthesiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Dariush Abtahi Clinical Research and Development Unit, Imam Hossein Hospital, Department of Anesthesiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2026 04 29 2026 05 04 Background: Dexmedetomidine offers established cardioprotective benefits, yet its specific impact on ventilation weaning and broader recovery metrics in cardiac surgery warrants a clearer definition. Methods: We enrolled 100 elective CABG patients in a double-blind randomized trial. Subjects received either a dexmedetomidine regimen (1 µg/kg loading dose, 0.3 µg/kg/h maintenance) or standard care. The study prioritized mechanical ventilation duration as the primary endpoint. We further analyzed cardiac injury markers alongside interleukin-6 levels and length of stay. Results: The median duration of mechanical ventilation was shorter in the dexmedetomidine group (210 vs. 310 minutes; p=0.004). This recovery benefit also found its way to biological indices, with the intervention group showing lower median amounts of CK-MB (65.00 vs 129.00 U/L; p<0.001), troponin I (0.07 vs 4.04 ng/mL; p<0.001) and five pack interleukin-6 (40.00 vs 70.00 pg/mL; p=0·004). As a result, patients had shorter times in the ICU (23.0 ± 24.9 vs. 32.25 ± 38.3 hours; p=0.023) and hospital (9 ± 5.2 vs 11±7 days; p<0.001). However, the drug disturbed hemodynamics stability with higher rates of hypotension (44% vs 22%; p=0.019), bradycardia (62% vs 24%; p<0.001) and need for temporary pacing (50% vs 16%; p<0.001). Conclusion: Administering dexmedetomidine accelerates extubation and attenuates myocardial injury. These benefits justify its use, provided the anesthesia team proactively manages the accompanying hemodynamic instability. https://aacc.tums.ac.ir/index.php/aacc/article/view/1626