Propofol_ is it necessary? (IV sedation for Plastic Surgery)

There are many negative articles on the propofol these days. It has a nick name “milk injection”.

People who are addicted to propofol, hospital that black-markets the propofol, criminal activities that take place in plastic surgery clinics with the usage of propofol are some contents that are on the news. Today, I would like to share about the use of propofol that is necessary in the plastic surgery clinics.
 
What is IV sedation.....?????

I have heard that IV sedation is dangerous. Can I not do it? There are some patients who ask such question. Also there are those who ask me to put them to sleep completely so that they do not know what is going on. Let’s looks at different anesthesia methods that are used in the cosmetic surgeries.


First, local anesthesia
We do not inject the anesthesia for the whole body but for a particular part. For example if you are having an eye surgery, the anesthesia would be injected on the eyelid. This is widely used when we conduct scar / wound reduction, skin tumor removal, or such surgeries on small parts of the body.

Second, Spinal anesthesia 
This is widely used in the obstetrics. The anesthesia is injected in the spines paralyzing the lower body so that the pain cannot be felt. This is used for abdomen / thigh fat transplantation in the plastic surgery clinics.

Third, General anesthesia 
General anesthesia paralyzes central nerves therefore requires breathing tube during the surgery. Therefore, the anesthesia and intubated. One can use the ringer solution but the breathing tube is safer.

Fourth, IV(intravenous) sedation
We use the intravenous injection with sleeping drugs for anesthesia. The most representative substance used is the propofol. If there is a respiratory problem, there would be big trouble. There is no breathing tube used. therefore, one must be aware of the anesthesia usage during the surgery.



As you can see in the graph above, if you go from sleeping stage to no breathing stage, your life becomes dangerous. This is IV sedation. So if the surgery is not a major one, then is would be safe to perform the surgery during the light sleeping stage. If you think that the surgery would be too painful and you want to sleep completely then general anesthesia is recommended.
You can find many articles to well know celebrities who abuse the usage of propofol. Actually, today, one cannot discuss about the IV sedation without the propofol.

Characteristics of propofol

1. Quick and smooth
2. Long lasting effect
3. No displeasure when awake

One can easily know why propofol is sued a lot. It has a quick effect on the body, lasts long and once you are awake, you do not feel bad.

If you watch the movie, Hannibal, there is a scene where an injection is used to make a person unconscious but there is no problem with breathing. Of course, such substance does not exist today. It would take another few decades for such substance to be made. But one can say that propofol is one that is really close to this substance. Therefore it is used a lot.

There are disadvantages of propofol as well. 
1. The injection is painful
2. Too much dosage can stop breathing (Dangerous to life)
3. Anesthesia status is not stable

However good a medicine is, it can be good or bad according to the person who uses it. Drinking can kill if one drinks it too much. It can be good for the body if you drink appropriately. Propofol is similar to drinking.

There are people with misperception. Propofol is not always good for the patient. Some do not remember anything and some feel unpleasant after using it. There are those who feel good after drinking and those who do not feel good as well.

All the substances that human make act differently from one person to another. However, there is one majority opinion.

Propofol being used as a drug to feel pleasantly good is wrong. Whether you are addicted to nicotine or drug, a human being has an ability to control one self. It is dangerous to think that one can escape the reality with the help of a medication.

Propofol is perceived to be a devil’s medication but if you manage and control the
usage properly, it is something necessary and useful. Actually, all medication are like that.

Today, we looked at IV sedation and propofol.

Thank you very much.