If there is one drug which truly enhances the arsenal of an anesthesia provider, that drug would be Propofol.
What is Propofol? Chemically described as diisopropylphenol, it is an emulsion; it is white, it contains soybean oil. It is a sedative-hypnotic agent that is used for the induction and maintenance of both general and sedation anesthesia.
Propofol is my friend. And Yours.
It has a very quick onset and short duration. When You need a colonoscopy, I can deliver squirts of this milk of amnesia in just the right amounts to keep you sleepy enough to not feel or remember a thing. You will wake up almost immediately after the procedure and just look at me incredulously when I tell you that it’s over and done.
It is also quite useful for cases where your surgeon can work on You using local anesthetic. As anyone knows who has been to the dentist, sometimes the administration of local anesthesia can burn and hurt. A couple of squirts of Propofol by me will help you nap through the numbing process, and never even feel the needle, let alone the actual surgery.
Let’s say You are having a minor procedure but you are just plain scared or uncomfortable about being in the operating room setting (I’m thinking podiatry, minor hemorrhoids, cataracts, breast biopsy for a small lump, and the like). *[ Note – most folks having these procedures get some type of sedation. There are an occasional few people who prefer NOT to be sedated at all, and that’s perfectly alright, too.] Propofol to the rescue after you’ve been numbed up, to give you that cat nap that you crave and need. It can easily be delivered as a “drip” and titrated to the desired effect. Combined with other IV drugs like benzodiazepines (think Versed – sedative) and narcotics (think Fentanyl – pain-killer), it creates an ideal sleep, where You can maintain your own airway and breathing, and I can watch over you and monitor your depth and adequacy of “LaLa-Land.”
For patients getting spinal or epidural anesthetics for their surgery (lower extremities and sometimes lower abdomen), a Propofol infusion will allow You to zone out for the duration of the operation. When a general anesthetic is required, where I will need to secure your airway with some type of breathing device, I administer Propofol in much much larger doses, as this will produce not only unconsciousness but also apnea (stop breathing) and a blunting of your gag reflex. Maybe more information there than you cared to know (sorry), but it definitely makes my job much easier, which ultimately makes taking care of You a much safer experience. After this “mega” dose of Propofol wears off (remember, I said it was short-acting), I can keep you asleep with either more Propofol, or other intravenous or inhalation agents, and assist your breathing as required.
I also use Propofol in “remote” settings throughout the hospital (any place away from the OR) – for cardioversions, where You need to be a little dazed for the jolt you will receive; same holds true for ECT – electroconvulsive therapy; and it is a lifesaver on any patient unit when someone needs to have a breathing tube placed – smaller or larger doses, it provides a short and quick solution to sedating a distressed patient.
So, say hello to my little friend…