What You Need to Know about Propofol

Dr. Mark Flanery weighs in on the safety and benefits of the maligned but widely used drug.

Since it was implicated in the death of Michael Jackson, many patients have had concerns about the drug Propofol. But if you have recently had surgery or undergone an outpatient procedure such as a colonoscopy, you likely received Propofol. The drug is used about 90 percent of the time for general anesthesia and about 70 percent of the time when moderate sedation is required for outpatient procedures. We asked Mark Flanery, M.D., a board certified anesthesiologist at the Covington MultiCare Center, about its safety. He has more than 30 years of experience as an anesthesiologist, is currently a Washington State Society of Anesthesiology board member and uses Propofol in seven or eight of every 10 procedures he does.

What is Propofol?
It’s a very versatile drug with many different uses, from mild sedation to full general anesthesia. It is administered intravenously (IV) to patients who then relax and go to sleep within 30 seconds or so, but wake feeling alert and relaxed soon after the IV is discontinued. It was developed as an alternative to sodium pentothal and has fewer side effects. Because of its versatility, Propofol is used in major surgeries such as joint replacement, as well as outpatient surgeries and invasive tests like endoscopies.

Is it safe?
Propofol is historically very safe when administered properly and monitored carefully. It is most safely given by anesthesiologists (M.D. or D.O.) and certified registered nurse anesthetists (CRNA), and should be administered in a licensed health-care facility or outpatient surgery center with monitoring equipment, resuscitative equipment and drugs, such as those present on a “crash cart,” nearby. A qualified person should be in constant attendance to interpret the monitors and intervene if a problem arises, and a recovery staff should ensure that any negative effects have diminished.

What if a patient has concerns?
On the day of surgery, the anesthesiologist or CNRA will meet the patient and discuss the anesthesia plan. This is your chance to ask about credentials and what to expect, and to raise concerns. The review should not conclude until all questions have been answered to your satisfaction. “That is your right as a patient,” says Flanery.”