Propofol, Michael Jackson, and what you need to know

Often in my practice I administer spinal injections requiring a fast-acting, safe anesthetic. I routinely use the drug Propofol.  Since the tragic death of Michael Jackson brought to the world’s attention the use of Propofol, I get asked about it frequently.

When used as intended–for surgical or diagnostic procedures conducted in an appropriate healthcare setting by a qualified anesthesia professional such as a Certified Registered Nurse Anesthetist (CRNA) or physician anesthesiologist, Propofol is fast-acting, short-lived, and very safe.  In fact, it is considered one of the safest anesthetics available.  I routinely use Propofol to quickly sedate patients for several thousand pain procedures every year.  It is metabolized very quickly, with the effect being that the patient is wide awake within minutes after a quick spinal injection.

Propofol is also routinely used with other quick outpatient procedures such as colonoscopy.  When used for other purposes, in other settings, by anyone other than a CRNA or anesthesiologist, the risks can be significant.

First, Propofol can be very addictive.  Abuse of the drug is becoming more common among anesthesia professionals and other healthcare providers who have easy access to it. Patients, however, should not worry about becoming addicted after receiving Propofol for a surgical or diagnostic procedure.  The risk of this happening is minuscule.

Second, the package insert for Propofol,which is approved by the FDA, requires that the drug be administered by healthcare professionals trained in the administration of general anesthesia–in other words CRNA’s or anesthesiologists.

The AANA and the American Society of Anesthesiologists feel so strongly about this that the two organizations published a joint statement in 2004 stating that whenever Propofol is used for sedation/anesthesia, it should be administered only by persons trained in the administration of general anesthesia and who are not simultaneously involved in the surgical or diagnostic procedure.

The bottom line is that Propofol is not a sleep aid and is not for recreational use.  However, it is safely and routinely administered by anesthesia professionals for thousands of outpatient procedures every day.

I hope this helps anyone who may be a little uneasy about undergoing an outpatient procedure that requires Propofol.  When conducted in the appropriate healthcare setting, it is extremely safe.

Written By Nathan Walters, M.D.


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