Writing for London's medical education title inCapitalHealth, one of London's leading experts in the use of anaesthetic drugs Dr Nigel Kellow explains when and how these powerful anaesthetic drugs should be used. His articles are featured on incapitalhealth

Michael Jackson died from a lethal dose of Propofol, a powerful anaesthetic drug, according to court documents just released in Houston, Texas. Conrad Murray, the singer's personal physician, had been regularly giving him intravenous doses of Propofol, apparently in combination with other sedative agents such as Midazolam, Lorazepam, and Valium, according to court records. Reports claim that the physician had been administering these sedative drugs to counteract Jackson's severe insomnia.

Dr Kellow MB BS FRCA MBA says: "There is no medical justification whatsoever for the use of Propofol for any purpose other than inducing sedation or anaesthesia, and only then in the hands of skilled and fully trained anaesthetists, with the essential equipment at hand to maintain the clear passage of air to the lungs, to manually assist breathing if it becomes depressed, which is a common consequence of Propofol in clinical use, and with the continuous use of equipment to monitor the amount of oxygen in the blood."

Dr Kellow goes on to say, "Propofol is the best anaesthetic agent available. After being given an intravenous dose of about 2.5 mg/kg of body weight, a volume of around 20 ml, most patients lose consciousness in one arm brain circulation time - the time it takes for blood to get from the intravenous cannulation site in the arm to the brain - typically less than one minute. The reports claim that Jackson had repeatedly been given much smaller doses of around 25 to 50 mg. Although such doses are often used by anaesthetists in hospital settings to sedate patients undergoing short procedures, the drug can quickly accumulate and repeated doses can lead to an anaesthetic dose being reached in a matter of minutes. When this occurs the patient's airway may become obstructed and they may simply lose the subconscious drive to breathe. This often happens in hospital settings and if it does the anaesthetist in attendance will simply take over the patient's breathing and may also put a plastic tube into the patient's throat to keep the airway clear."

"There is much debate over whether Propofol should be used by non-anaesthetists. If small sub-anaesthetic doses are given it is usually safe, but life-threatening problems can arise within seconds if a patient's airway becomes obstructed or if they lose their desire to breathe. If either happen the doctor in attendance must be able to both insert a tube into the patient's throat and to take over their breathing. If these do not happen brain damage can occur within two minutes and the patient can be dead within five minutes. The risks of using Propofol become significantly magnified by combing its use with other sedative drugs. In practice the only group of doctors who have the necessary skills to manage the problems posed by the use of Propofol is anaesthetists, and its use by any other doctor is rare and potentially difficult to justify if problems occur."

"A picture is emerging of Michael Jackson having been given a lethal cocktail of drugs by a non-anaesthetist, and for spurious reasons. Propofol and the other drugs he was given are anaesthetic and sedative drugs and induce sedation or anaesthesia. They do not induce sleep which has a different EEG pattern.! "

We are probably going to hear more on this story in the coming days and weeks.

Source
inCapitalHealth