Propofol, often called "milk of amnesia" due to its white, emulsion appearance, is a rapid-acting intravenous sedative-hypnotic agent used to induce and maintain general anesthesia and provide sedation. It is widely used in hospital settings for surgical procedures, diagnostic tests (e.g., endoscopies), and to sedate intubated, critically ill patients in the Intensive Care Unit (ICU) due to its fast onset and quick recovery times.
Description. Propofol injection is used to help you relax or sleep before and during surgery or other medical procedures. This medicine is an anesthetic and a sedative. Propofol may also be used to sedate coronavirus (COVID-19) patients who need mechanical ventilation in the intensive care unit (ICU).
This drug is currently marketed as Diprivan (AstraZeneca) and is a sterile emulsion for use in human and veterinary medicine. Propofol is commonly referred to as the “milk of amnesia.”
Yes, propofol can cause tongue swelling, often as a sign of a serious allergic reaction (angioedema) or sensitivity, presenting as swelling of the lips, tongue, face, or throat, which requires immediate medical attention due to potential breathing difficulties. It's a known serious side effect, sometimes alongside rash, itching, or trouble breathing, and needs urgent care as it can be life-threatening.
Propofol works quickly; most patients are unconscious within five minutes. "When the procedure is over and we stop the intravenous drip, it generally takes only 10 to 15 minutes before he or she is fairly wide awake again.”
Since propofol stimulates the dopamine expression in the central reward system, however, it bears a potential risk of addiction and induces addiction-like behavior in animal models. Additionally, a subgroup of healthy volunteers reported having experienced euphoric moods after propofol administration.
During the procedure, the endoscope is passed through your mouth or nose, which can cause irritation and mild trauma to the throat. The discomfort may also result from the anesthesia or sedation used during the procedure, which can leave your throat feeling dry or sore as the effects wear off.
It is possible that postprocedure testing at 1–2 hours after completion of procedure may confirm complete return of cognitive function to baseline. As noted above, patients who underwent endoscopy with Propofol had return of psychomotor speed and driving skills to baseline 2 hours after endoscopy.
You should not take propranolol with other beta-blockers, calcium channel blockers, or certain antidepressants (like fluoxetine, bupropion) and migraine drugs (rizatriptan) without strict medical supervision, as these combinations can dangerously lower heart rate/blood pressure; also avoid epinephrine, clonidine, and NSAIDs (ibuprofen, naproxen) unless directed by a doctor due to risk of severe side effects or reduced effectiveness. Always tell your doctor about all medications, vitamins, and supplements you take.
On June 25, 2009, the American singer Michael Jackson died of acute propofol intoxication in Los Angeles, California, at the age of 50.
In the US, opioids are also the most used recreational substances among anesthesiologists, although 26% of professionals abuse of more than one substance concomitantly. The most frequent opioids among US anesthesiologists are injectables, chiefly fentanyl and sufentanil.
Propofol is more effective than the morphine, atropine, and suxamethonium regimen as an induction agent to facilitate neonatal nasal endotracheal intubation. Importantly, hypoxemia was less severe, probably because of the maintenance of spontaneous breathing.
Propofol injectable emulsion is contraindicated in patients with a known hypersensitivity to propofol or any of propofol injectable emulsion components. Propofol injectable emulsion is contraindicated in patients with a history of anaphylaxis to eggs, egg products, soybeans or soy products.
Michael Jackson used the potent anaesthetic propofol so frequently to help him sleep that he came to depend on it as a sort of alarm clock, an official involved in the investigation has revealed.
The "10-8-6 rule" for propofol is a simple manual algorithm for starting total intravenous anesthesia (TIVA) in adults: a 1 mg/kg loading dose, followed by 10 mg/kg/hr for 10 minutes, then 8 mg/kg/hr for the next 10 minutes, and finally 6 mg/kg/hr for maintenance, aiming to reach and maintain a target blood level efficiently. It's a step-down infusion to account for rapid initial drug distribution, but modern Target-Controlled Infusion (TCI) pumps often provide more precise dosing, especially in varying populations like children or the elderly, where this manual rule is less accurate.
The anesthesiologist will stop the propofol infusion as your procedure finishes. They know precisely when to do this based on your surgery's progress. Once the infusion stops, you'll wake up within minutes because your body rapidly clears the medication.
“We have noted, as have others, that when utilizing propofol as the sedative agent, patients recover much more rapidly than they do with traditional sedation,” he says. “That being said, most requirements have us keeping those patients away from driving, operating machinery and similar activities until the next day.”
Red flags after a colonoscopy include severe abdominal pain, high fever, persistent vomiting, significant rectal bleeding (more than a little spotting), difficulty passing gas or stool, dizziness, or shortness of breath, which can signal rare but serious complications like perforation or internal bleeding and require immediate medical attention. While mild cramping and gas are normal, these severe symptoms shouldn't be ignored and warrant contacting your doctor or going to the ER.
A sore throat after intubation usually improves within a few days to a week, with symptoms like soreness and hoarseness often easing significantly within 24-48 hours. However, in more complicated cases, especially with prolonged intubation or difficult tube placement, healing can take several weeks, requiring potential evaluation by a Speech and Language Therapist or ENT specialist if symptoms persist beyond a week or two.
The time it takes to wake up from propofol varies. It depends on the dose, how long the procedure lasts, and the patient's health. Usually, people start to wake up in 10 to 15 minutes after the infusion stops. But it can take longer to fully recover from propofol's effects.
Psychedelics: Drugs like LSD and psilocybin can cause vivid hallucinations, emotional shifts, and changes in time perception. These are often referred to as “trips.”
They should routinely monitor for signs and symptoms of acute propofol withdrawal, such as abrupt agitation, tremors, tachycardia, tachypnea, and hyperpyrexia.