Propofol: Is it ‘dangerous’?

In coverage of the first week of the trial of Dr. Conrad Murray, Michael Jackson’s personal physician, Times articles consistently described propofol as a “dangerous” anesthetic.

Jackson died in June 2009 from the effects of propofol, which Murray says he gave the singer nightly over two months to get him to sleep. The doctor is accused of involuntary manslaughter.

Reader Jim Gould of Burbank took issue with the description of the anesthetic:

“The Times’ repeated, erroneous description of the excellent, safe general anesthetic agent, propofol, as ‘dangerous’ should be of some concern to the thousands of anesthesia practitioners who correctly use the drug as an anesthetic agent of choice in a wide range of surgical procedures every day.

“The Times should carefully avoid their error in the many continuing articles expected on the trial of Dr. Conrad Murray. This is emphatically not to say that Dr. Murray had any business using the excellent, safe anesthetic agent outside an appropriate surgical setting, as a ‘sleeping pill!’”

Readers’ Representative Deirdre Edgar responds:

Propofol killed Michael Jackson — but does that mean it’s dangerous?

As Jim Gould points out, the drug is widely used by anesthesiologists. And according to the RxList website and drugmaker AstraZeneca, propofol is approved for use in children as young as 2 months.

Dr. Barry L. Friedberg, a Newport Beach anesthesiologist, also wrote to The Times in defense of propofol, used under the right circumstances.

“Critically ill ICU patients receive propofol for days on end and live because their breathing is mechanically supported,” he wrote. “What is lethal is the failure to monitor the patient’s airway and breathing and appropriately intervene when circumstances dictate.”

The American Society of Anesthesiologists issued a statement on propofol in September saying the drug is “often used for procedures requiring sedation.” However, the group added, propofol “should never be used outside of a controlled and monitored medical setting.”

Prosecution witnesses in the Murray trial testified this week about the slim margin of error in dosing the drug.

“If you’re off a little bit and you’re giving too much drug, it can actually extend to hours” before a person awakes from the sedation, Dr. Steven Shafer, a leading expert on propofol, testified Thursday.

Times senior copy chief Mark McGonigle, who oversees the news copy desks, said Gould made “an excellent point.”

More recent articles have characterized propofol as “powerful” or “potent.”

Now, did Murray use it properly with his patient, Jackson? That’s for the jury to decide.