How Propofol Affects a Patient

The Today Show - NBC—August 3, 2009

The drug that is front and center in the controversy surrounding Michael Jackson’s death - Propofol - is one that is routinely administered every day by doctors across the country. But unlike the way Jackson reportedly used it, the doctors giving it are anesthesiologists in sterile, monitored operating rooms, like the ones at Hospital for Special Surgery in New York. NBC’s chief medical editor, Dr. Nancy Snyderman, reported from inside HSS to look at how the powerful drug is used on patients.

Propofol, sometimes called “the Milk of Amnesia” is a powerful sedative. It is for use in controlled environments and has no indications for use anywhere else. When administered safely, it causes intense drowsiness followed by unconsciousness - a condition that, while perfect for surgery, requires vigilant monitoring and airway maintenance to ensure the safety of patients.

“If you know how to handle an airway and ventilate a patient, the margin of safety is great; but at some point … they are going to start to snore and obstruct,” said Thomas Quinn, MD, an attending anesthesiologist at HSS. “Then you need someone with some experience to handle an airway - like an anesthesiologist. Don’t try this at home.”

Quinn regularly administers Propofol safely before surgeries of all types. “A normal circulation time is about 10 or 15 seconds [after getting the drug], then you are out,” he said. Once the patient is unconscious, Quinn keeps watch on the patient’s respiration rate and other vital signs before, during and after the surgery as they come out from under sedation.