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September 27th, 2011
05:06 PM ET

Some patients question propofol, doctor says

With the opening of the trial for Michael Jackson's doctor Conrad Murray, we'll be hearing the word "propofol" a lot again.

The Los Angeles County coroner ruled that the pop superstar died on June 25, 2009 from "acute propofol intoxication." The anesthetic was among the drugs found in Jackson's body at the time of his death, according to the autopsy toxicology report.

Propofol, whose trade name is Diprivan, is commonly used to sedate people undergoing colonoscopies, and leaves patients feeling well-rested when they wake up, experts say. It is not approved to treat sleep disorders, which is reportedly how Jackson was using it.

And since the singer's death, doctors have had many conversations that begin with patients saying,  "I don’t want that stuff. That’s the stuff that killed Michael Jackson," says Dr. John Dombrowski, a member of the board of directors of the American Society of Anesthesiology.

But it's also provided a teaching opportunity for physicians to explain to patients that medications like propofol do not directly kill or harm patients; it's the improper administration and inattention to detail that can be lethal.

Propofol should be administered only by people trained in giving general anesthesia, and who are not involved in the conduct of the surgery or diagnostic procedure, according to the The U.S. Food and Drug Administration.

Prosecutors have accused Murray of taking part in Jackson's overdose of propofol, alleging that Murray gave the pop icon a makeshift intravenous drip to administer the drug, intended to help Jackson sleep.

This drug should never be used outside a hospital or other controlled medical setting, experts say.

Irrespective of Jackson, propofol has been concerning because it has been abused by health care workers in some cases. There are some who say it should be a controlled substance that needs to be put on a "schedule"  of drugs that have very limited distribution and strict accounting of their use. The American Society of Anesthesiologists has pushed for this scheduling, but no decision has been made on it.

"But if done safely, with the right training, it’s been [the case] for millions of patients that they go to sleep and they wake up very comfortable and safe," Dombrowski said.


soundoff (36 Responses)
  1. Laraine Frank

    I can tell by looking at Dr Murray's eyes that he is not guilty..This was a tragic accident. OJ Simpson was innocent also, while Casey Anthony is guilty. My hope is this jury gets it right!

    September 27, 2011 at 18:40 | Report abuse | Reply
    • Drummergrrl

      OJ was innocent?

      September 27, 2011 at 18:46 | Report abuse |
    • Leo

      The tooth fairy and Santa Claus are real, too, right? How's life in your fantasy world?

      September 28, 2011 at 08:18 | Report abuse |
    • Chartreuxe

      It's good you're not on the jury, then, Laraine. They'll hear the evidence and make their decision based on *that.*

      September 28, 2011 at 14:57 | Report abuse |
    • quitsa

      Michael Jackson wanted Propofol. He was a raging drug addict and would doctor shop until he got what he wanted. This guy was stupid enough to treat him.

      September 28, 2011 at 16:20 | Report abuse |
    • Tom

      I don't see murder or malpractice here but I do see some poor choices by MJ and Murray both. I am sure Murray had no intention of Jackson dying – he was probably trying to get him off the drugs over time and took over for another doctor who had already enabled Jackson in getting any drug he wanted, anywhere and time he wanted.

      September 28, 2011 at 17:46 | Report abuse |
    • SurRy

      What?! He administered the drug for a non-approved use (sleep agent.) He administered an anesthetic agent that is only given to patients in health care facilities who are under the care of someone who is trained to administer anesthetic agents. It is not even administered by all physicians. It requires special monitoring (heart rate, respiratory rate, blood pressure, oxygen saturation, etc.) and emergency equipment in the event the patient requires advanced airway management or other advance life support interventions. You have no idea what you are talking about. He's lucky that is all he has been charged with.

      September 28, 2011 at 18:19 | Report abuse |
    • Johnny

      Wait. There can't possibly be anyone who beleives OJ is or ever was innocent. My god.

      September 29, 2011 at 07:57 | Report abuse |
    • Terry

      I definitely don't think it was intentional on Dr. Murray's part. He definitely looks like a tortured soul in that courtroom. With that said, he was definitely guilty of malpractice and probably involuntary manslaughter. I kind of understand what Laraine is saying but I disagree that he is not guilty.

      September 29, 2011 at 08:13 | Report abuse |
    • PEGGY ROZELL

      PLEASE READ MY REPLY TO YOU AT THE BOTTOM OF THE COMMENTS. SORRY I REPLIED TO YOUR COMMENTS THE WRONG WAY.

      October 7, 2011 at 13:45 | Report abuse |
  2. cara

    Propofol is a bad drug and I can offer personal experience - my own. I was given Propofol during a biopsy procedure and it caused me to have a seizure on the operating table. Sadly, there are drugs out there that should not be administered and this may be one of them. Obviously, Michael Jackson was using this drug in an inappropriate and unintended way - being anesthetized is not the same as natural sleep. So, attempting to use it for the purpose of sleep is bad judgement. But the drug itself seems to have underlying factors that warrant concern. Even in an appropriate application. His misfortune was hitting upon an unethical doctor who would administer a dangerous drug improperly. That was Russian roulette with too many bullets in the chamber.

    September 28, 2011 at 01:08 | Report abuse | Reply
    • Leo

      Cara, not every drug affects every patient the same way. For example, you might be able to take sulfa antibiotics without any problems, but those drugs make me horribly sick. However, I can take penicillin, but I know plenty of people who can't. I got hives from percocet that I was given for post-surgical pain, but some people seem to think percocet is a "fun" drug. (It sure wasn't fun for me.) And I was given propofol for sedation during a colonoscopy, and I did just fine.

      The drug is safe and appropriate with most patients for use in a controlled medical setting for carefully monitored sedation during medical procedures. Like any drugs, some patients will react badly.

      If this still doesn't convince you, let me as you this: are peanuts safe for human consumption? I'd say yes. I love peanut butter and peanut candies. In contrast, those products will kill some people. Same principle behind the use of various medications.

      September 28, 2011 at 08:24 | Report abuse |
    • personal

      My husband was given propofol for surgery yesterday. It worked like a charm. The fact that you had a seizure doesn't mean it shouldn't be used at all.

      September 28, 2011 at 11:22 | Report abuse |
    • Chartreuxe

      Five times I've had Propofol and it's never been a problem for me. You, on the other hand, Cara, are sensitive to it for some reason. That does *not* make Propofol a bad drug. It means that *you* shouldn't have it.

      Don't make general assumptions based on your own personal experiences. A bad reaction to a medication doesn't mean the drug itself is bad. Sometimes it's a 1 in 100,000 outcome.

      September 28, 2011 at 15:00 | Report abuse |
    • quitsa

      Propofol is a good drug whe used appropriately by medical staff. Unfortunately the street use has become the new normal. Jackson got exactly what he wanted, from a dr who was too stupid to say no to this temper tantrum raging drug addict – Jackson wanted a drug a to knock himself out and he did it all by himself.

      September 28, 2011 at 16:25 | Report abuse |
    • AnesDoc

      A seizure due to propofol is virtually impossible. Induction drugs and most other general anesthetics, are a treatment for seizure activity. A more plausible explanation is local anesthetic injected in a blood vessel during tissue removal. Your description of a seizure during biopsy while under propofol sedation would indicate this.
      There is a reason why propofol is never used for ECT. Patients won't seize when energized.
      Always discuss your concerns with your anesthesiologist when going to surgery in the future.

      September 28, 2011 at 20:38 | Report abuse |
    • CalgarySandy

      People who cannot sleep eventually become psychotic from lack of REM sleep. There can be no faulting Michael from trying something, anything to get to sleep. You lay awake all night in deep stress and never feel right during the day. Being tired out does not put you to sleep if you have insomnia. I have been there and been treated with all manner of drugs that targetted mental illness. None helped me sleep. When a new one came out and it worked I became a different person. All those idiot mental health workers diagnosed me with every possible disorder. My Family doctor offered me sleeping pills and it was a miracle.

      If you have never suffered from chronic insomnia you cannot understand why Michael frantically looked for a solution. I feel bad that he did, I feel really bad for his kids, and I feel bad for this doctor that got caught up in Michael world.

      September 28, 2011 at 22:25 | Report abuse |
    • haremettle

      Your experience is by far the minority. I have never heard of anyone having seizures related to propofol. I tend to doubt that your experience was caused by propofol as well. It is not a "bad" drug as you put it. It is in fact a very good drug when used right.

      September 29, 2011 at 05:37 | Report abuse |
    • Blossie

      How are you certain it was the propofol? Propofol can be given to stop seizures, perhaps it was the local anesthetic given for the biopsy?

      September 29, 2011 at 12:45 | Report abuse |
    • Carasanidiot

      Cara hopefully any doctor you see in the future will suggest that you do your own procedures on yourself since you apparently know more than they do. What a tool.

      September 29, 2011 at 13:35 | Report abuse |
    • Julian

      I agree that people don't always understand the risks they are accepting. Even other people responding here are saying "it is only your problem". However, if you go under for a colonoscopy or other procedure are you really willing to die from it? People are really bad at making risk judgement because they never think the bad thing will happen to them. Sure it may be rare, but any time you take a risk you need to be comfortable with bad consequence. It is like gambling - if you bet $100 then you need to be comfortable with losing $100. Too many people go under general anesthetic for unnecessary reasons and procedures, or otherwise face surgical risks unnecessarily. Do you think when a woman dies from breast augmentation (actually fairly common due to infections or improper anesthetic administration) that it was worth the risk? Unless you're facing life or death, definitely avoid general anesthetic.

      October 3, 2011 at 17:45 | Report abuse |
  3. hunky223

    It was used on me for colonoscopy and the experience was pleasant , it was mixed with one other drug and I did exactly wake up right after my colonoscopy finished. Amazing Drug...to Cara....you may had an allergic reaction to the drug, not all drugs suite all.

    September 28, 2011 at 07:15 | Report abuse | Reply
  4. andrew

    I also had propofol for my colonoscopy and I was extremely grateful that the whole thing was over quickly with no sense of awareness. I remember the doctor turned the lights off and then they were back on and the whole thing was over. You wake up quickly with no lingering grogginess (sp?). I agree with hunky – it is an amazing drug.

    September 28, 2011 at 09:15 | Report abuse | Reply
  5. Fay

    In my family we have an enzyme deficiancy that doesnt break down anestesia properly, and if given muscle relaxer first, it further slows down the break down time. This happened to many family members and we were in comas and breathing machines for some times up to a week. They now make meds specific to break down faster to avoid this. I know that people can blame doctors or meds, but it really boils down to each persons body and genetics to how they are affected!

    September 28, 2011 at 09:34 | Report abuse | Reply
  6. Toughmom

    My son was put under with Propofol every day for 30 days during his radiation treatment. This is not a drug that I would ever think you would want to use outside of a hospital setting and especially to induce sleep that is not intended for a medical procedure. Somebody made a bad judgement call allowing Michael to not only take it on a regular basis but to also administer it himself (so I hear). I agree that everyone's body reacts differently to different things but I have a feeling he just down right overused the drug and possibly combined it with other drugs that he shouldn't have. Sad situation any way you look at it.

    September 28, 2011 at 10:43 | Report abuse | Reply
  7. SmartBlondie

    I was a veterinary nurse for 20 years, and used propofol safely to anesthetize hundreds of animals, including frail tiny kittens. It can lower heart rate and oxygen saturation significantly, so close monitoring 100% of the time is critical. MJ was given Propofol along with several other narcotics, which is extremely dangerous. It is a general anesthetic, and is clearly labeled for use as such. Any other use is careless and negligent.

    September 28, 2011 at 15:09 | Report abuse | Reply
  8. Tom

    Anyone who thinks that MJ didn't already have a drug problem when Murray arrived on the scene is blind to his history and the evidence. He was addicted to pain meds for years and eventually he built up a tolerance – even to drugs like morphine. He had grown extremely physically frail, weak, and compromised. Propofol was just the current drug he had switched to abusing. It wasn't just a bad doctor it was over a decade of abuse, addiction, and neglect for getting THERAPY in addition to TREATMENT. His call for a NEW doctor was in a way a cry for help.

    September 28, 2011 at 17:39 | Report abuse | Reply
  9. Monroe G Tinker RN MSN

    I am currently watching the Jackson trial. First, I am NOT taking the side of the MD in this trial.

    However, in this mornings report on TV at 1030 PST I heard the correspondant state that the physcian was " asking Jacksons staff if they knew CPR" she made this statement as if the MD did not know CPR.

    I have served as a Paramedic in the NYC Fire Department and currently work as a RN in a intensive care unit. CPR is PHYSICALLY DEMANDING. the physcian may have asked because he needed relief not because he did not know CPR. When a correspondant makes a statement like this it really makes CNN appear ignorant. DO YOUR HOMEWORK BEFORE YOU MAKE STATEMENTS LIKE THIS. I am certain that the Dr Gupta is aware of how truly physical resusitating a human being is.

    September 29, 2011 at 13:40 | Report abuse | Reply
  10. TERROR ALERT

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    October 2, 2011 at 18:48 | Report abuse | Reply
  11. PEGGY ROZELL

    YOU OBVIOUSLY DON'T UNDERSTAND EVIDENCE. YOU ARRIVE AT YOUR OPINIONS BASED SOLELY ON WHAT YOU "WANT" TO BELIEVE! YOU SHOULD REALLY LISTEN TO THE FACTS AS THEY ARE ALLOWED INTO EVIDENCE BY THE JUDGE. YOU ARE NOT THE FACT FINDER IN ANY OF THESE CASES & EACH OF THEM ARE COMPLETELY DIFFERENT!

    October 7, 2011 at 13:20 | Report abuse | Reply
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      MY REPLY WAS MEANT FOR LORRAINE FRANK-SORRY I ENTERED IT INCORRECTLY.

      October 7, 2011 at 13:29 | Report abuse |
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