I know the whole Michael-Jackson-death-by-propofol thing is no longer making the news, but I just wanted to share my experience today.  This is what’s happenning to anesthesiologists everywhere (I presume) now that propofol has become a household word.

Today, on three separate occasions, during my shift in the preoperative evaluation clinic, I had the pleasure of educating patients about the common and proper use of propofol after they had expressed some desire to not end up like Michael Jackson.

1. A 40-something woman coming for evaluation before bariatric (gastric bypass) surgery asked me what I thought about how MJ died.  I told her it was tragic, shouldn’t have happened that way, and was the result of a negligent doctor.

2. A 70-something woman called to ask about the anesthesia for her colonoscopy and was concerned that she would be getting the same drug as MJ.

3. And finally a 40-something woman coming for evaluation before a gynecologic procedure, who even brought in a tabloid article underlined in certain parts where propofol was explained.  She even went as far as claiming to have an allergy to propofol so that it wouldn’t be given to her for her procedure.

Well, I will take this opportunity to educate the public (or the minority that will actually read this post) about the history of this newly popularized, but not really new drug.

Propofol has been around since the 1970s.  It was first synthesized and tested in 1977 by Imperial Chemical Industries.  It’s first formulation resulted in allergic reactions due to the solvent it was prepared in; however, it was reformulated and gained widespread use.  It’s advantages over other widely used intravenous anesthetics at the time was that it was very short-acting (meaning that patients fell asleep quickly after administration and woke up quickly after discontinuation) and had some anti-nausea effects.  Propofol has been a popular anesthetic ever since.  Annual sales in the U.S. is somewhere between $350 million and $400 million, and worldwide annual sales are around $700 million.

So, propofol is not some new experimental drug; it has been around for over 3 decades and is quite popular among anesthesiologists and intensive care doctors for the reasons mentioned above.  These doctors are trained in using the drug safely, as opposed to the one who is responsible for Michael Jackson’s death.  Although most doctors have some knowledge of the drug, most do not use it on a daily basis, and therefore shouldn’t.  It is also important to stress where the drug is to be used -  a place where a patient’s vital signs can be monitored regularly (i.e. not for home use).  Rest assured, it can be and has been provided to patients for sedation and general anesthesia in a controlled, monitored setting (such as an operating room) for over 30 years.