Skip to content
My WebMD Sign In, Sign Up

Pain Management Health Center

Font Size

Propofol: Expert Q&A

Answers to questions about propofol use and abuse.
By
WebMD Feature
Reviewed by Laura J. Martin, MD

Propofol is a strong anesthetic that's used for surgery, some medical exams, and for sedation for people on ventilators -- never as a sleep aid. It's given by IV and should only be administered by a medical professional trained in its use. It takes effect in a matter of seconds.

"It is very fast-acting and works by slowing brain wave activities, says John F. Dombrowski, MD, an anesthesiologist/pain specialist at the Washington Pain Center in Washington, D.C.

Recommended Related to Pain Management

Visiting the ER for Chronic Pain

You’re a chronic pain patient who takes several prescription narcotics to control your symptoms. Then one weekend, excruciating pain lands you in the emergency room. There, a doctor grills you about your medications, in part to make sure that you’re a legitimate pain patient, not someone seeking drugs. What can you do to help the ER doctor to believe you? It’s not always easy to tell chronic pain patients from drug-seeking patients, says Howard Blumstein, MD, FAAEM, president of the American Academy...

Read the Visiting the ER for Chronic Pain article > >

Dombrowski, who is a board member of the American Society of Anesthesiologists, talked with WebMD about propofol's uses and abuses.

Does propofol have approved or off-label uses besides for surgical anesthesia?

No."I know of no off-label use or need for propofol," Dombrowski says. "It has a perfect place in the medical community, and that's in a surgical suite or ambulatory care setting."

Is it unusual for propofol to be used outside of a hospital setting?

"It's only to be used in a medical setting," Dombrowski says. "Outside of a hospital, it may be used in an ambulatory care center or a doctor's office, but only if it's administered by a trained professional, not by the doctor performing the procedure. You can't do your operation properly and do sedation at the same time. You can't serve two masters. That will lead to sloppy surgery or sloppy anesthesia care, and patients don't deserve that."

How dangerous is propofol?

Propofol is a potentially deadly drug in the wrong hands, and there is no room for error.

"It's only designed for people trained to do advanced cardiac life support," Dombrowski says. "It induces a deep level of sleep and sedation, and it can cause your blood pressure to go down and your breathing to stop. You can die. Patients have to be monitored beat by beat, minute by minute."

Can any doctor administer propofol, or is it more controlled?

"There's no DEA (Drug Enforcement Administration) licensing requirement, so the answer is no. It's not controlled and any physician can use it," Dombrowski says. "But I hope that physicians who are not trained to use it will have the insight to say, ‘This is out of my comfort zone. What business do I have using this? None.'"

Can people get addicted to propofol? Is there any prolonged or repeated use of propofol?

“The concern for addiction is always there, but while there is abuse potential among hospital personnel who have access to propofol, for the general public, that potential is just not there," Dombrowski says. "It’s an access issue. The general public has no access.”

"As for repeated uses, only if you are getting multiple procedures done. But there's no one out there saying, ‘Hey, I'm going to get another hernia repair' just to get some propofol."


After someone has been on propofol and "wakes up," how would they feel? How different is it from sleep?

"You feel alert, unlike with [the anesthetic] pentothal, which left patients feeling really worn out and hungover," Dombrowski says."But while propofol induces sleep, it's not a clean, clear sleep."

Are there any statistics on propofol abuse?

"Abuse just doesn't occur, and if there's any abuse potential, it's so small that it's not enough to talk about," Dombrowski says."There's no access to it, and there's no reason someone would want it."

Reviewed on September 29, 2011

Today on WebMD

pain in brain and nerves
Top causes and how to find relief.
knee exercise
8 exercises for less knee pain.
 
acupuncture needles in woman's back
How it helps arthritis, migraines, and dental pain.
chronic pain
Get personalized tips to reduce discomfort.
 
illustration of nerves in hand
Slideshow
lumbar spine
Slideshow
 
Woman opening window
Slideshow
Man holding handful of pills
Video
 
Woman shopping for vegetables
Slideshow
Sore feet with high heel shoes
Slideshow
 
acupuncture needles in woman's back
Slideshow
man with a migraine
Slideshow