Michael Jackson murdered? (page 3)

shamus100

I'm glad that piece of human trash is gone. Whoever did or didn't do it did society a favour.

I think his doctor should get all his money.

Propofol: A Dangerous Kind of Rest

Posted at 11:42 am CT on July 31, 2009

The widely-used but little-discussed drug has provoked a number of “what is Propofol?” news segments, including a piece by ABC’s Primetime: Crime that brought a camera crew to the University of Chicago Medical Center earlier this week. That segment, reported by former MTV newsman Chris Connelly aired Wednesday night, and you can watch it here .

For 30 seconds (from -2:17 to -1:47) of the video, you’ll hear briefly about research by Avery Tung, associate professor of anesthesia and critical care for the Medical Center (you will also see a rat being anesthetized with a completely different drug, halothane). In the early part of the decade, Tung conducted an NIH-funded research project examining relationships between sleep and anesthesia, and published several papers and scientific abstracts looking at how propofol mimicked the effects of actual sleep. After Tung sat down with ABC, I spent a little more time with him discussing the anesthetic and his research.

Q: First of all, what is propofol, and how often is it used?

Tung: Propofol is given intravenously to induce anesthesia in surgical patients and to provide sedation for patients in the Intensive Care Unit. It’s the most common induction agent of anesthesia in current use. It pretty much has replaced pentothal because it has fewer side effects and it makes people feel better when they wake up.

Q: What side effects does propofol have?

Tung: It can cause a decrease in blood pressure, it can depress or even stop breathing, and it can cause pain on injection.

Q: And because of those side effects, its use is restricted?

Tung: The package insert with the drug states that it should only be used by persons trained in the administration of general anesthesia, which in this hospital means an anesthesiologist. In the ICU, it is restricted only for use in intubated, mechanically ventilated patients.

Q: Why restrict it to use under an anesthesiologist’s guidance?

Tung: Propofol can be deceptively easy to use. Because people recover so quickly, there’s a temptation to use it in places which aren’t safe. But it’s stronger than other drugs, and can clearly destabilize blood pressure and breathing, Users can easily slip over the line from sedation to general anesthesia, develop blood pressure or breathing difficulties, and need specialized resuscitation measures.

Q: Why is it used in non-surgical cases in the intensive care unit?

Tung: For a number of reasons. Mechanically ventilated patients can be uncomfortable, or experience pain and anxiety. They might also be a danger to themselves and others due to agitation, or need help to tolerate the ventilator. Not everybody in the ICU needs sedation, and some need to be sedated fairly deeply so that they are only partially responsive to stimulation.

Q: You chose to study the effects of propofol on sleep deprivation. Is sleep deprivation an issue in the ICU?

Tung: Sleep deprivation is a huge issue in the ICU, and has been documented since the 1980’s. Because of potential pain and anxiety, because the lights are always on, because there is noise always present and nurses are checking on patients on an hourly basis, there is really no quiet time. The circadian rhythms and light cycles that people are normally exposed to aren’t as present in an ICU setting either. No one knows whether sleep deprivation adversely affects outcomes in the ICU because there’s no way to set up a control for sleep, but many of the effects of sleep deprivation can clearly make care in the ICU more difficult.

Q: Tell me about the first propofol and sleep study you published ( Anesthesia and Analgesia . 2001 May;92(5):1232-6) .

Tung: The first thing we did was to sedate rats with propofol for the entire period they would normally be asleep…and see how they would behave afterward relative to how they behaved beforehand, compared to rats that were allowed to sleep naturally. What we found is that rats were no more sleep deprived, as measured by EEG criteria, after a period of propofol sedation, than rats that underwent naturally-occurring sleep.

We concluded that the need to sleep was not accumulating inside rats that received propofol and therefore either propofol was preventing their “sleep debt” from building up or propofol was, like sleep, helping rats to discharge it.

Q: You tested this conclusion again using a different experiment ( Anesthesiology. 2004 Jun;100(6):1419-26); how did that one work?

Tung: In the second experiment, we sleep deprived a rat and looked at the recovery from sleep deprivation. Normally when a rat is sleep deprived, it shows a rebound increase, a transient increase in sleep for a while as they sort of discharge their sleep need or sleep debt.

(Rats in this study were deprived of sleep for 24 hours by being placed on a platform above a pan of water. Whenever rats begin to sleep, the platform rotates, forcing them to wake up and walk to avoid splashing down in the water)

So we then allowed rats to sleep naturally or gave them a period of sedation with propofol and looked to see how they recover. What we found is that recovery in rats given propofol occurred as quickly as recovery in rats allowed to sleep normally. We concluded that, at least in rats, subjects can discharge their sleep debt under propofol sedation to the same degree as they are able to do it using naturally occurring sleep.

Q: But does that mean that propofol sedation is the same as sleep?

Tung: Propofol sedation is nothing at all like sleep. Sleep is reversible with external stimulation - if you shake somebody, they wake up. Propofol is obviously not like that. Sleep shows a characteristic pattern of EEG behavior, while propofol does not. (For instance, Tung explains, cyclical patterns of REM and nonREM sleep are not observed during propofol sedation, in rats or humans) Sleep, in general, preserves blood pressure and the ability to breathe and propofol does not. They are very different states.

Q: All of your propofol research has been in rats, has there been any research done in humans along these lines?

Tung: No, there has not. It does appear that humans given propofol for prolonged periods do not appear to be sleep deprived when you turn off the drug. No data exist to support the specific use that has been alleged in the Michael Jackson case (using propofol as a treatment for insomnia),. Use to facilitate regular sleep is not at all safe. The benefit is way outstripped by the risk…if there is any be nefit.

Nobody is advocating its use outside a hospital for patients that are not critically ill. That is outside the boundaries of currently accepted care.

mkr32208

LOL a corrupt doctor getting paid 150k a week (or was it month) who cares, he killed a pedophile he should get a medal.

I would have been only too happy to choke that SOB to sleep for FREE much less 150k!

Satanus

He should simply have switched to weed. It would have relaxed him, and made him eat something. Not much money in that for the docs, and of course, it's illegal.

S

Big Tex

MJ was on a death spiral, and he found a doctor with a sketchy past and borderline ethics. Now he is the scapegoat. Jackson's family and his fans want someone to blame, never mind the fact MJ was a spoiled, dysfunctional drug addict, they now have found one and he's going to hang.

Then everyone will feel better.

mkr32208

Well isn't it always news when a black man murders a white woman?

The Almighty Homer

The Doctor shouldn't be all to blame in this situation, MJ had in the past been a drug abuser and even had to go to re-hab for the abuse of pain killers.

From what it sounded like he was pretty much addicted to Propofol in its use.

When someone is taking a drug such as that to sleep every night, thats pretty abnormal and the doctor should have seen that

and stood against it, instead he himself administered it over a period of 6 weeks to the careless addict.

In this case the money issue overrode the health issue and now the end result may be the doctor will be charged with manslaughter

lose his license and put an end to his medical career, not to mention some jail time.

Michael Jackson murdered?

shamus100

The Almighty Homer

Propofol: A Dangerous Kind of Rest

mkr32208

Satanus

Big Tex

mkr32208

The Almighty Homer

The Almighty Homer

JimmyPage

The Almighty Homer

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