Until recently, propofol was a drug known mainly by operating room personnel. In June 2009, propofol’s name was on everybody’s lips worldwide as the drug responsible for the death of the King of Pop, Michael Jackson.
Propofol is the most widely used preoperative anesthetic given by injection in the United States, replacing thiopental, which had reigned supreme for four decades. When injected intravenously, propofol is used to rapidly and gently induce anesthesia before the use of inhaled anesthetics, or it can be given alone by a continuous infusion to maintain anesthesia. Consciousness is lost in less than sixty seconds, and, unlike with thiopental, the patient recovers within minutes after the drug is discontinued and does not experience a hangover. This makes it a very valuable drug for outpatient (day-case) surgery.
Because propofol (Diprivan) can cause sudden and significant depression of breathing and a drop in blood pressure, it must always be used cautiously and in an operating room or facility in which breathing support is available immediately. When taken with Valium-related benzodiazepines, such as lorazepam (Ativan), the risk of respiratory depression is heightened.
After weaker sleep-producing drugs ceased to be effective, Michael Jackson’s personal physician began giving him propofol for insomnia at the star’s home every night for six weeks before his death. In the last days, additional drugs, including lorazepam, were given to facilitate his sleep. His death has been ruled a homicide, and his physician was convicted of involuntary manslaughter for failing to monitor the safe use of propofol, and he was sentenced to a four-year jail term.
The King of Pop was apparently not the only one addicted to propofol; other well-documented reports of abuse and addiction have appeared recently. These have primarily involved anesthesiologists and other operating room personnel who have easy access to the drug.
SEE ALSO Thiopental (1934), Valium (1963).
Propofol, a very commonly used, rapid-acting anesthetic, is administered via IV injection to induce anesthesia, or via IV infusion to maintain anesthesia. This drug should only be administered in a facility equipped to support heart and breathing complications. Michael Jackson, sadly, was not treated with propofol under these conditions.