Michael Jackson and Propofol

michael_jackson_timeLet me say two things right off the bat. First, I’m a huge Michael Jackson fan. I have talked about his tragic death on this blog several times before. Secondly, I am a trauma surgeon. I have added qualifications in Surgical Critical Care. I use the drug Propofol (trade name: Diprivan) quite often to take care of my trauma patients. (This is going to be a thoughtful discussion about Propofol and its uses. If you’re looking for rhetoric, hype and finger-pointing, you’ll need to look elsewhere.)

Common scenario: a 25-year-old intoxicated patient is involved in a motor vehicle crash. The patient is confused and combative at the scene. The patient has a combination of a head injury and acute alcohol intoxication. The prehospital providers were able to control the patient and transport the patient into the emergency room. For whatever reason, the patient becomes more combative. For the patient safety and the safety of those of us who are trying to take care of the patient, a cocktail of drugs is given to the patient in order to facilitate placement of the patient on mechanical ventilation (a breathing machine). In order to keep the patient sedated during the evaluation and early treatment, Propofol is used.

Propofol is listed as a hypnotic agent in pharmacology books. If given an appropriate doses, sleep and relaxation can be induced within seconds to a couple of minutes. Propofol can be given as a drip to keep patients asleep for long periods of time — days to weeks. All drugs have side effects and Propofol is no different. Propofol can lower the blood pressure of patients to dangerous levels. In certain patients, even small doses can induce apnea (respiratory failure – patients can stop breathing). (more…)