A10: Basics of Propofol

[@yesyes2113]

Very crisp and concise

[@KeithOtisEdwards]

When I had a hip replacement last year, I don't know how long I was put under, but I had the most amazing dream-hallucination of my life. I was in a realistic cargo spaceship when a klaxon began sounding. I and the other crew immediately entered transporter tubes, then there was an overpowering *WOOOOOOSH!* and when it ended, I was in a wheelchair beside a desk. An older nurse at the desk asked if I knew where I was, and (having been asked that question over and over since the ambulance EMTs picked me up) I recited the street address of the hospital. I told her that the anesthesia was an amazing experience, but she wasn't interested. But then, on the way back to my room, in a dark portion of the corridor, two guys in scrubs approached me and said, "Man, you had Propofool! You gonna be _folked up!_ " "Tell me about it," I replied. "I thought I was in outer space!" "No!" one said. "That shirts gonna mess your mind up for _weeks!_ " I assumed that they were two anesthetists who had been doing Propofol for kicks between surgeries. When I returned to my bed, I found a bill from the hospital covering my time before the surgery. It was for $1,111.11. I assumed that I was still hallucinating, but the bill remained the same. (The total deductible was about $5,000.) Days later, I came to the conclusion that the guys in scrubs who warned me about Propofol's aftereffects were a hallucination. I believe that all the people who have had major surgery and saw themselves entering a long tunnel moving toward a bright light where they saw Jesus or their their late family members were likewise experiencing Propofol hallucinations. I just have a better imagination. Since then, I've spoken to many people who have had Propofol for such things as a colonoscopy or minor eye surgery, and they reported that they experienced no such hallucinations. So was my outer-space dream brought on by Propofol or some other anesthetic agent?

[@pocketpoolboy]

I think it might depend on the duration of anesthesia and adjunct medications such as fentanyl. Colonoscopy patients are only under for 20 minutes on average. I would assume your emergent hip-surgery was likely 2.5 hours and you had some significant analgesics added to the line for the extremely-painful procedure.

[@okidokidoc]

Great quality video, doc! keep em coming please!

[@katcao8370]

Hi, thanks for the breakdown. Do you know how Prop maintains HPV? Thanks.

[@allnaturalfitnesscoach6287]

Do you require intubation using propofol for a colonoscopy? Does breathing actually stop?

[@mattarnold3847]

My last surgery I tried as hard as I could to stay awake just to see if I could. I lasted 20ish seconds propofol is no joke. The deluded they gave after surgery was nice tho

[@jenpatrick4741]

I had surgery today and when I was given it I had a reaction I never had before. A faint ringing that got louder and louder and louder and gave me a headache till I fell asleep. It’s 13 hours later and I still have a headache.

[@siphonostele]

Nice video, John.

[@veronical1757]

Is this the one that causes burning pain during induction?

[@alexisdior90]

Yes. A bit of lidocaine mixed in helps decrease that burn

[@bahiachibi895]

Thank you

[@diablovideos7517]

I have a question. What is my chance of survival if I infuse myself with 3000 mg of propofol at a flow rate of 80 mg/min (the rate I can get from a drip infusion)? I am 100 kg, 187 cm, 45 years old. Thank you.

[@muzzamilabrar]

What would be the efficacy of precedex Vs propofol , in a neurosurgical HDU ? , Would raised ICP be any contraindication to precedex , as precedex would allow easier weaning from assisted ventilation and arousable sedation would help in GCS assessment during awakening trials.

[@sunshr2011]

In which are the cases we need propofol 50ml What is your thought on propofol MCT-LCT vs LCT

[@kerrylattimore2684]

Very informative. Thanks.

[@KatJ3st]

and it made me cry - alot

[@thatjamericankidd6637]

Explain self medicating propofol

[@mwngw]

Really wanted to hear about post-op cognitive side effects.

[@KatJ3st]

I cried. As soon as I woke up - I also had a nightmare and said stuff that bothered the nurses when waking up. I'm still creeped out.

[@KatJ3st]

@Micheal Corn what does that mean please? I know only about 4,% of patients experience these nasty side effects. I'm over 60 so Ketamine is out too!

[@BoogieDownProduction]

@@KatJ3st While its true that ketamine is not often used in older patients; I dont think there is a absolute rule. Regardless, I am sorry that happened to you. I encourage you to remember these effects and let your anesthesia team know next time you have surgery - they will do what they can to minimize or completely avoid these side effects next time.

[@KatJ3st]

@@BoogieDownProduction you bet I did! I told the nurse in pre op I was allergic to Ketamine 😉

[@camiloleal9391]

Hey! Why did you stop uploading videos? Your way of explaining it’s so good!! Come back.

[@john2pham]

Hi Camilo, thank you for the compliment. I’m finishing up my residency this year and have a few too many projects and exams to focus on. I hope to get back to making more videos in the next few months!

[@fifferfiffer2]

for me, first i saw that the ceiling started to wobble, or bend, in a water wave like way, i was hoping that no harder hallucinating will happen, and that wave look of the ceiling went away after 5 sec, than i started to feel my breathing to be paralyzed, for like 20 sec, than i slept. I knew that my breathing will stop but i hoped that first i will go sleep than the breathing stops, but unfortunalty went the other way, was not the painful but it sucks to go through this, cause i can clerly remember being slowly suffocated, which i tried to compensate with deeper breathe, but of course slowly that did not help either, then i was just making suffering gasping noises, they asked what is wrong, i said i cant breathe, they said evertyng will be ok, then i slept, 2 hours in GA, waking up was no painful but really drugged, like being drunk but cleaner feeling , more like when u are woken up like 4 am, assuming u would normally wake up around 8, i heard everything, understood, but was so hard and lazy feeling to open my eyelid, for like 5 hours, it took 24 hours until this drugged feeling went away..... that was combined with that i should not eat 6 hours before the surgery, then they figured that they want me to prepare for another GA cause of complications, and this was a unsuccessful deviated septum surgery, where i still had to wear the nasal tampons for 2 days, then i could breathe trough my mouth only for 2 days, meaning u cant sleep really, then the second GA was not actually needed but overall for 52 hours i eat 3 eggs and 4 small bread, and barely slept for 2 days....altough there is no pain feeling but the whole procedure made me very drugged, tired, blood pressure went up to 170/110 with 115 bpm pulse, took 2 days to bring it down to 120/80 with 80bpm.... i would day overall worth it cause no pain is happening at all, i did not know that they started to administer it, only by seeing the hallucinoid effect of it, there was no burning feeling

[@ouissemaissaoui7013]

I went thriugh GA whan i was about 12 years old now i am 29 and i still remember vividly that suffocating feeling I really hated it

[@jconstanta13]

Just earned my doctorate degree after this video hahah

[@TheChicMedic]

Please make more videos

[@urmom7250]

They was using it on me and it saved my life but messed me up bad

[@8QQ8]

@ur mom , how did it mess you up?

[@KatJ3st]

Same here! Huge bruising on my arm. Nightmares and crying upon waking. Disturbing emotional state for 24 hours A week of fretful depression

[@b21704]

Believe or not IT does not work on me at all. They have given me high dose for induction and i did nit went to sleep. I felt like stepping into freezing water and was schocked by IT and could not breathe. I felt everything and remember everything. The intubation was painfull but not that much. On the other hand when they put catheter, without painkillers because they were thinking i was asleep the pain was agonizing. Like someone put hot steel rod into my penis and slowly started to tear it apart. My heart rate was sky rocketing. Started shouting do loud and wanted to stand but o was strapped to the table. Could nit see because anasthesiologist put stickers onto my eyes and could not hear because she pit headphones onto my ears. They realized that i am awake and gave me more analgesics. I think i fainted then. Remember when i was "woken up" and every Word they said and the procedure of extubation. Is this normal? I knew that my mind is very powerfull but this?

[@hawaiianfilter]

I asked the anesthesia I could either count back from ten or tell them when I was asleep. They immediately put the mask on me. I guess they didn't want to hear from me any longer. I understand that deep anesthesia is similar to brain death.

[@vivianfox3794]

🤣🤣🤣🤣 this is great😇

[@andrewsmith3257]

Tell them when your asleep? How would u know? 🤔

[@BoogieDownProduction]

They should have explained it to you. Counting backwards is fine if you are only doing IV anesthesia, but if they are placing a breathing tube then they need to get as much oxygen into your system as possible.

[@annak4891]

it was because of preoxygenation - it means that the anesthesiologist needed to change nitrogen in Your lungs to clear oxygen, it takes about 5-8 minutes to do it right and protect Patient from hipoxia during intubation:) Thank You for Your comment! as a future anesthesiologist I will prepare my Patients for mask ventilation by giving them more information why I do it :)

[@camilamontoya3447]

Question, I'm 25 age and I've been put to sleep 7 time total all for cosmetic reasons with no complications with anesthesia before however the most recent #7 when i was getting my breast done as i was injected i felt as if my brain was struck with a hammer and then immediately i stopped breathing. I was not able to inhale or exhale. I felt like i was suffocating from within. It was the worst feeling ever and i couldn't even breath or move then i fell asleep. I woke up and was told everything went well. My question is, is the feeling of suffocation normal? I'm assuming yes since they told me there was no complications. It was the worst feeling ever in my life the feeling of suffocating and being held down. I literally couldn't even gasp for air. Please answer me. Please

[@anesthesiain1096]

Hi Ms. Montoya, I am so sorry you had this experience, it sounds terrible. From what you are describing it sounds as though you had a rare complication during anesthesia which we term intraoperative awareness. This can occur at the beginning, middle, or end of anesthesia and there can be many reasons why this may occur. There are both patient risk factors and the type of anesthetic used which my increase your risk of having intraoperative awareness. If this is something that continues to cause you distress, please consider discussing this with your anesthesiologist or primary care doctor. Please feel free to PM me with any additional questions.

[@32ahmmed]

👍

[@finalbossoftheinternet6002]

Rip Michael Jackson

[@pat0583]

RIP 1958 - 2009

[@RMalsawmtluanga]

Why? Michael Jackson addicted to propofol?

[@aviator2117]

@@RMalsawmtluanga he died from propofol.

[@RMalsawmtluanga]

@@aviator2117 Very dangerous and Very Sad. May he Rest in Peace.

[@tomtenberg]

Watch to the end for doses?

[@India-rd6wi]

I had Propofol used on me for a common procedure. Unfortunately, as the drug was being administered into my arm it felt like the fires of hell. Until I went under, I was in extreme pain and in agony. I was screaming that it was burning. Even though I was in pain, the anesthesiologist continued to push it in.

[@mcbaggins12]

Of course he kept pushing it in. You needed a certain dosage for the procedure and, besides, the best way to dull the pain is with…the propofol.

[@veronical1757]

This answers my question. I was the same way. Excruciating pain when I was going under for my BR surgery 😔

[@joesimmons5692]

My anesthetist inserted lidocaine into my IV before administering the propofol. I felt nothing.

[@ohheyalan123]

@@mcbaggins12 Propofol does nothing for pain. It’s not an analgesic… You need to add a analgesics/opioid to stop pain.

[@RitaMBuda-tz6bi]

It killed Michael Jackson for Christ's sake. They gave that shit to me when I had my surgery. I wish I never had it.😡😡😡😡😡😡

[@EYEBALLKLOTT]

Sharps container

[@mikeearls126]

i was expecting a bit of a more dumbed down version without medical jargon. I will continue searching

[@leeroymagalliano3362]

Propofol killed the king of pop michael jackson

[@sarahnabors1464]

😢

[@maggyebraheem4469]

No the Dr. did. He left the room while Michel was not being monitored.The Dr. OD him.

[@jennakuder1496]

No, the doctor did. The doctor didnt even put him on a flat surface for CPR.

[@KatJ3st]

No his so called doctors did!

[@elcheapo9444]

I could use 100ml of that stuff. It would solve everything.

[@mansdoctooor]

thank you