Dr.Conrad Murray-Propofol Still An Option

[Suzie B]

What I don't understand is why they have not taken into account more expert opinion as in law they ask what would a reasonable doctor have done? From what I have read, docs have said that they would not have given propofol with 4 Benzo drugs, they certainly wouldn't give more than 2 and that would be in a hospital environment with constant monitoring. Along with all the other obvious evidence, it is immoral, disgusting and disturbing that Murray is practising now.

 

[Soundmind]

I am not so sure. Michael also admitted that he had propofol before. So, why would Murray have to tell him that he was safe if he already taken it before and didn't die or suffer long-term effects. Also, if Michael hired him for the sole purpose of given him propofol, he didn't need Murray's blessings that it was safe, since he already hired him for that end

as I said before Murray was there since AT LEAST march , he was obviously going to be part of mj's medical team . they tried to get Abrams , when that failed murray contacted a friend of him to assist him but that one turned him down due to family and business . they were searching for an anaethesist to add to the team . an anaethesist and Murray was their to revive if anything went wrong . you know history tour and the two doctors with the mini clinic .

Dr.Adams statements of what happened at that meeting in march and murray's doctor frined will definitely tell us what murray's role intially was .

I bet it was to revive only , that why once he felt no other doctor was willing he asked for astronomical numbers from AEG . Murray took a two- job salary , he was the one who was going to give and the one who was going to monitor . He did give but he failed to monitor and MJ ended up dead .

 

[Ramona122003]

as I said before Murray was there since AT LEAST march , he was obviously going to be part of mj's medical team . they tried to get Abrams , when that failed murray contacted a friend of him to assist him but that one turned him down due to family and business . they were searching for an anaethesist to add to the team . an anaethesist and Murray was their to revive if anything went wrong .

Dr.Adams statements of what happened at that meeting in march and murray's doctor frined will definitely tell us what murray's role intially was .

I agree with all of that.

I was just referring to your statement that Murray was the doctor that Michael was talking about to Lee. Although his doctor said it was safe, I do not think he meant Murray since he already took propofol. So, he didn't need Murray to tell him it was safe as long as he was watched.

Most likely it was a doctor he was meeting with during the History Tour that told him that propofol was safe and could get him through the tour.

 

[Soundmind]

" I did not give him anything that should have killed him " = it was safe .and as Beachlover said IT IS SAFE , ofcourse with appropriate medical equipment available just incase something went wrong .

 

[elusive moonwalker]

the question is if murray was giving it to mj for 6 weeks. what caused him to mess up so badley on the 25th? can the corroner determine by the liver etc how long he had been getting the diprivan for.we know murray wants to run with the whole 6 week thing cause it helps with is mj was addicted i was getting him off it. did murray tell the police about the amount of benzos he gave mj over the 6 weeks aswell. did he mess up on the 25th cause hed never given mj the amount of benzos b4 that he had given him on the 25th

Now, I am a nurse and doctors never give IV's in the hospital. Nurses do that 99% of the time as well as start the IV's. Doctors in my hospital NEVER start an IV. Never. Most are clueless how to operate an IV Pump. I don't now if there was an IV pump to control the rate and flow. That would be in my opinion, VERY important. Certain drugs like this need to be very controlled and how can you do that without a pump so you know the rate is correct?

the COD said acute toxication. now acute in medical terms mean a sudden sharp (large?) amount? is is possible that the diprivan wasnt given to mj through an iv. its not something u can just inject directly into the vein. it needs to be done over a period of time..is the word acute telling us something interms of how the drug was given to mj.beachlover?

 

[Ramona122003]

the question is if murray was giving it to mj for 6 weeks. what caused him to mess up so badley on the 25th? can the corroner determine by the liver etc how long he had been getting the diprivan for.we know murray wants to run with the whole 6 week thing cause it helps with is mj was addicted i was getting him off it. did murray tell the police about the amount of benzos he gave mj over the 6 weeks aswell. did he mess up on the 25th cause hed never given mj the amount of benzos b4 that he had given him on the 25th

the COD said acute toxication. now acute in medical terms mean a sudden sharp (large?) amount? is is possible that the diprivan wasnt given to mj through an iv. its not something u can just inject directly into the vein. it needs to be done over a period of time..is the word acute telling us something interms of how the drug was given to mj.beachlover?

Going purely by Murray's word, he gave Michael only propofol for six weeks. He claimed to have given him 50mg a night until June 23, no benzos were used during this time period going by his own word.

If that is true, there is no way that Michael slept for more than a few minutes before he woke up, going by what doctors have said. Every expert said 50mg of propofol by itself does almost nothing, even if give during a expanded amount of time.

Propofol is a drug that is hard to track, even if you do the proper test. That is why people were afraid that they wouldn't find it. If they found enough to claim Michael died of propofol, then the report would had stated they found trances of the drug. However, the tox specially said acute toxication. This means that no only did they found propofol, they found alot of it. Especially since most experts said that if they even found trances of propofol in Michael's system, Murray needed to be arrest because that is too much.

Even if Murray did everything right to this point, however, it still does not excuse the fact that he left the room when the patient was sedated. Even if Michael was an addict, how do you explain that to a jury?

 

[Soundmind]

Acute Toxicity



•Pathogenesis

Limited information is available on the acute toxicity of propofol in humans. The IV LD50 of propofol, administered as the emulsion formulation, averaged 53 and 42 mg/kg in mice and rats, respectively, while the oral LD50 of propofol, administered as a solution in soybean oil, was 1230 and 600 mg/kg in mice and rats, respectively.
•Manifestations

Overdosage of propofol would be expected to produce manifestations that principally are extensions of the drug’s pharmacologic and adverse effects. At least 2 fatalities have been reported following intentional self-administration of a 400- or 1600-mg dose of propofol.

•Treatment

In the event of overdosage, therapy with propofol should be discontinued immediately, and appropriate symptomatic therapy initiated. Overdosage of propofol is likely to be associated with cardiorespiratory depression. If respiratory depression occurs, patients require administration of oxygen and institution of artificial ventilation. In addition, for cardiovascular depression, elevation of the lower extremities, increasing the rate of IV fluid administration, and/or use of vasopressors or anticholinergic agents are suggested.

In toxicology, the median lethal dose, LD50 (abbreviation for “Lethal Dose, 50%”), LC50 (Lethal Concentration, 50%) or LCt50 (Lethal Concentration & Time) of a toxic substance or radiation is the dose required to kill half the members of a tested population. LD50 figures are frequently used as a general indicator of a substance's acute toxicity.

 

[Soundmind]

Pharmacokinetics



The pharmacokinetics of propofol after IV administration are best described by a 3-compartment model and they appear to be linear. The pharmacokinetic profile of propofol is characterized by rapid distribution of the drug from blood into tissues, rapid metabolic clearance from blood, and slow redistribution of the drug from the peripheral compartment.
The pharmacokinetics of propofol have been studied in adults and in pediatric patients 3–12 years of age. Distribution and clearance of propofol in pediatric patients are similar to those reported in adults. There is no evidence of gender-related differences in the pharmacokinetics of the drug. Studies in adults indicate that the pharmacokinetics of propofol do not appear to be affected by chronic renal failure or chronic hepatic cirrhosis; however, the pharmacokinetics of propofol have not been studied in patients with acute renal or hepatic failure.

•Absorption

Following a single (e.g., 2.5 mg/kg) IV injection, propofol has a rapid onset because the drug is distributed rapidly from plasma to the CNS. The onset of action of propofol as determined by time to unconsciousness (i.e., loss of response to voice command) usually ranges from 15–30 seconds, and depends on the rate of administration. Following a single rapid IV injection, propofol blood concentrations decline so rapidly that peak plasma concentrations cannot be readily measured; duration of action of the drug usually is about 5–10 minutes.

Following IV administration of repeated rapid IV injections of propofol (e.g., an initial induction dose of 2.5 mg/kg followed in 3 minutes by several 1-mg/kg doses, administered at 6-minute intervals), peak and trough venous blood concentrations of the drug in samples obtained immediately before each rapid IV dose and 2 minutes afterwards were 4–10 and 1–2.5 mcg/mL, respectively. When propofol is used alone for induction anesthesia, plasma concentrations of the drug necessary to provide loss of eyelash reflex, loss of consciousness, and the possibility for initiation of surgery in 50% of patients (IC50) are estimated to be 2.1, 2.7–3.4, and 15.2 mcg/mL, respectively.

To provide adequate maintenance anesthesia when propofol is used as a component of total IV anesthesia, initial plasma propofol concentrations of 2–7.5 mcg/mL followed by 2.5–5 mcg/mL have been suggested. To achieve such concentrations, some clinicians have used a pharmacokinetic computer model interfaced with a target-controlled infusion (TCI) device† (e.g., Diprifusor®, AstraZeneca; not currently commercially available in the US) to administer the appropriate amounts of propofol.

Following initiation of a continuous IV infusion of propofol, there is an initial rapid increase in blood concentrations of the drug, which is followed by a slower rate of increase, probably associated with a rapid distribution from the blood to tissues. In a limited number of patients undergoing sedation with propofol in an ICU and who received a 1- to 3-mg/kg rapid IV (‘‘bolus’’) dose followed by a constant-rate IV infusion (3 mg/kg per hour) for 72 hours, peak blood concentrations of the drug in samples obtained over the 72-hour period ranged from 0.77–15.3 mcg/mL. Limited data indicate that plasma propofol concentrations necessary to provide sedation in 50% of such patients (IC50) are estimated to be 0.47 mcg/mL for a sedation score exceeding 2 (when measured by the Ramsey scale) and 1.1 mcg/mL for a sedation score exceeding 4.

Since propofol is rapidly distributed from CNS to inactive storage sites, recovery from anesthesia is rapid. Following a single rapid IV injection of propofol, most patients will awaken as blood concentrations of the drug decline to approximately 1 mcg/mL, and improvement of psychomotor performance (as measured by patient response to verbal command) usually occurs at blood propofol concentrations of 0.5–0.6 mcg/mL.

Recovery from anesthesia may be more rapid following administration of propofol than barbiturates (e.g., thiopental, methohexital) or possibly, etomidate. In a double-blind, comparative, crossover study in healthy adults receiving IV propofol (2.5 mg/kg initially, followed by 1 mg/kg 3 minutes later) or thiopental sodium (5 mg/kg initially, followed by 2 mg/kg 3 minutes later), improvement of psychomotor performance (as measured by patient response to verbal command) was faster in patients receiving propofol (mean time: 33 minutes) than in those receiving thiopental sodium (mean time: 62 minutes). In addition, psychomotor performance was impaired for up to 5 hours after IV administration of thiopental sodium and for 1 hour after propofol.

•Distribution

Propofol is highly lipophilic and is rapidly distributed from plasma into human body tissues, including the CNS. Following IV administration, the drug is widely distributed, initially to highly perfused tissues (e. g., brain), then to lean muscle tissue, and finally to fat tissue. In humans, equilibration of propofol between blood and CSF occurs within about 2–3 minutes. Following rapid IV injection of propofol, the volume of distribution of the drug during the initial, steady-state, or elimination phase reportedly ranged from 13–76, 171–771, or 159–1011 L, respectively. Following long-term continuous IV infusion (longer than 72 hours) in patients undergoing sedation in a critical care setting, the volume of distribution at steady-state was much higher than that reported following short-term IV infusions (shorter than 9 hours), 25.5 vs 1.8–5.3 L/kg, possibly because of increased peripheral distribution associated with the long-term infusion. Volume of distribution of propofol may be reduced in geriatric patients when compared with younger individuals, perhaps because of a reduction in the volume of highly perfused tissues relative to body mass or a reduction in perfusion of these tissues associated with decreased cardiac output.

Propofol is approximately 95–99% bound to plasma proteins, mainly albumin and hemoglobin. Protein binding appears to be independent of the plasma concentration of the drug.

Propofol readily crosses the placenta. Limited data indicate that the ratio of umbilical venous to maternal venous blood concentration at parturition is about 0.7 after rapid IV (‘‘bolus’’) administration of 2.5 mg/kg of propofol to women undergoing cesarean section. In one study, mean propofol blood concentrations of 0.078 mcg/mL were detected 2 hours after delivery in neonates whose mothers had received a propofol infusion of 5 mg/kg per hour for about 26 minutes while undergoing cesarean section. Propofol reportedly is distributed into human milk in low concentrations.

•Elimination

Pharmacokinetic data indicate that plasma concentrations of propofol decline in a triphasic manner, with the drug undergoing a very rapid initial distribution. In adults receiving IV propofol either as a single rapid injection or a continuous infusion, in the initial (distribution) phase (t½α) reportedly averages 1.8–9.5 minutes, in the second (redistribution) phase (t½β) averages 21–70 minutes, and in the terminal (elimination) phase (t½γ) averages 1.5–31 hours. It has been suggested that the terminal plasma half-life may not affect clinical outcome as substantially as the distribution half-life, because once blood propofol concentrations decrease below the range required for hypnosis, rapid awakening from the anesthesia will occur.

Propofol is rapidly and extensively metabolized in the liver. Propofol mainly undergoes glucuronidation at the C1-hydroxyl position, but hydroxylation of the benzene ring also may occur to form 4-hydroxypropofol which is subsequently conjugated with sulfuric and/or glucuronic acid. Hydroxypropofol has been reported to have approximately 1/3 of the hypnotic activity of propofol. Hydroxylation of propofol is mediated by the cytochrome P-450 (CYP) isoenzyme 2B6 and to a lesser extent by the 2C9 isoenzyme.

Propofol is excreted mainly in the urine principally as sulfate and/or glucuronide conjugates; less than 0.3% of propofol is eliminated unchanged in the urine. Limited data indicate that less than 2% of a dose of propofol is eliminated in feces.

Following IV administration of propofol by rapid injections or by a continuous infusion in healthy adults or in critically ill patients undergoing sedation, total body clearance of the drug is high and ranges from about 1.3–3.5 L/minute. Total body clearance of propofol may be substantially lower in geriatric patients compared with younger adults, possibly because of decreased hepatic metabolism resulting from decreased hepatic blood flow. Since plasma clearance exceeds hepatic blood flow, it appears that the drug also is metabolized at extrahepatic sites. Mean total body clearance of propofol appears to be proportional to body weight; obese patients have a substantially higher body clearance than leaner individuals.



--------------------------------------------------------------------------------

AHFS Drug Information. (CR) Copyright, 1959-2009, Selected Revisions July 2007. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

 

[indranee]

Ok. Maybe you need to go to medical school to understand the drug more. You do NOT intubate everyone on this drug. You only intubate if you give a dose high enough to stop them from breathing which you WOULD do if you were giving them surgery as in the CNN video. That person was having surgery and you would need to give more.

I am not here to argue with you since you obviously don't understand how the drug works. It was used on Michael in Germany also when he was touring and as a singer I am sure he did not wish to be intubated during his tours.

I am not debating at all whether this drug is meant for home use. It is not. Not ever. Why Michael thought it was is not my business. Who told him that is not my business. He obviously thought it was a good drug because he used it in Germany for his concerts there. He didn't die in Germany.

I don't know what is your point except to not understand how the drug works.

I did not go to med school but I do know enough to know when a doctor (or a medical professional) is talking out of his or her ass. my entire family is filled with doctors, I did pre-med in college, AND I've been in and out of hospitals and anesthesia enough times to know exactly what's kosher and what is not. as such, whether or not I know "enough" about Propofol is not as important as the fact that I know Murray is lying like there's no tomorrow, and there's no ifs, ands, or buts about it. the question is -- who's with him and what did he actually do that the coroner knows about.

 

[elusive moonwalker]

Going purely by Murray's word, he gave Michael only propofol for six weeks. He claimed to have given him 50mg a night until June 23, no benzos were used during this time period going by his own word.

he bought the benzos and diprivan together in may.so it hardly fits with his story. i just wish the police would bleeding do something so we can actually discuss what is happening rather than just trying to speculate about what might be the arguments and the evidence.im drained b4 its even begun

 

[terrell]

I am not so sure. Michael also admitted that he had propofol before. So, why would Murray have to tell him that he was safe if he already taken it before and didn't die or suffer long-term effects. Also, if Michael hired him for the sole purpose of given him propofol, he didn't need Murray's blessings that it was safe, since he already hired him for that end.

As for Lee, I really cannot see why she would lie. She reported the propofol to the media before the LAPD. Before then, everyone was talking about painkillers and doctor shopping. Lee was the only person who stepped up and said this drug could be the thing that killed him and he was not shopping for drugs or doctors. Turns out everything she said was true.

So, even thought I have no clue about the phone call and that hot/cold feeling, Lee have so far proven to be telling the truth. She may had misinterpreted the situation, but I do not believe she would outright lie about it. Especially since I see no motive for he to lie about that detail.

So true. She was called and said to be out of line by some of the lawyers; now look, she was right. And she warned Jackson of this drug and refuse to give it to him. WHy couldn't Murray do the same thing? Idoit.

 

[Soundmind]

murray was telling him it was safe , do I need to post articles here that confrim what Beachlover said , less than 1% of people given propofol for sedation need intubation or even facial mask ?
MJ was the one asking for all the extra measures in case anything went wrong , he was the one who wanted an anaethesist to give it to him PLUS murray to revive just INCASE something went wrong . He was the one who went to see Abrams , he asked Lee in april for an ANAETHESIST eventhough murray was already part of the team, he was already in LA with his girlfriend .

with statics like the ones I read , MJ had no reason to feel murray was not able to give him propofol .

 

[Ramona122003]

murray was telling him it was safe , do I need to post articles here that confrim what Beachlover said , less than 1% of people given propofol for sedation need intubation or even facial mask ?

As a doctor, however, it is still odd that he didn't have a backup in case things do go wrong.

Although, didn't Michael's cook said that Murray always brought down two oxygen tanks. If that is the case, why was Michael not incubated that night. Especially after being given all those benzos.

Alot of what Murray did makes no sense, especially if we are to believe that 6 week timeframe.

The biggest mystery of all, however, is why Michael decided to take propofol without an anaethesist. He seemed to want all these extra measures, but in the end he allowed Murray to give him propofol without the safety measures that he wanted. Seems like Michael was really desperate and Murray took full advantage of him.

 

[StaceyMJ]

I was under the impression that everytime someone is anaesthetised they should be intubated? Every time I have been put under I've been intubated and can't think of anyone who hasn't been that I know...although I'm no expert. But yeah, to be intubated for 6 weeks or more...that would be a very sore throat. Makes you wonder what the hell Murray was doing.

 

[Soundmind]

As a doctor, however, it is still odd that he didn't have a backup in case things do go wrong.

Although, didn't Michael's cook said that Murray always brought down two oxygen tanks. If that is the case, why was Michael not incubated that night. Especially after being given all those benzos.

Alot of what Murray did makes no sense, especially if we are to believe that 6 week timeframe.

The biggest mystery of all, however, is why Michael decided to take propofol without an anaethesist. He seemed to want all these extra measures, but in the end he allowed Murray to give him propofol without the safety measures that he wanted. Seems like Michael was really desperate and Murray took full advantage of him.

very true , the equipment were a MUST , because he was using a drug with zerro margin for error . and MJ did try alot to find someone specialized first , we don't know what murray told him , we don't know what he showed him , we know MJ tried to get an anaethesist PLUS murray since day one . if he believed first murray was enough he would not even bothered looking for doctors , murray was THERE FIRST .

 

[Soundmind]

I was under the impression that everytime someone is anaesthetised they should be intubated? Every time I have been put under I've been intubated and can't think of anyone who hasn't been that I know...although I'm no expert. But yeah, to be intubated for 6 weeks or more...that would be a very sore throat. Makes you wonder what the hell Murray was doing.

ofcourse that depends on the dose of propofol given , I'm talking about small doses here .

 

[Ramona122003]

very true , the equipment were a MUST , because he was using a drug with zerro margin for error . and MJ did try alot to find someone specialized first , we don't know what murray told him , we don't know what he showed him , we know MJ tried to get an anaethesist PLUS murray since day one . if he believed first murray was enough he would not even bothered looking for doctors , murray was THERE FIRST .

However, Michael must had been incubated on some nights if what the cook and others claimed is true. Michael did have breathing problems and that could explain why no one thought much of Murray bring down the tanks.

Still, why didn't Murray have a backup. Are doctors not train to account for everything, no matter how unlikely. Especially since Michael usually have oxygen tanks anyway for his breathing. None of this make any sense.

 

[Soundmind]

However, Michael must had been incubated on some nights if what the cook and others claimed is true. Michael did have breathing problems and that could explain why no one thought much of Murray bring down the tanks.

Still, why didn't Murray have a backup. Are doctors not train to account for everything, no matter how unlikely. Especially since Michael usually have oxygen tanks anyway for his breathing. None of this make any sense.

again I'm talking about very small doses given over a relatively short period of time , not high doses. we don't know what murray was doing , what amount he was giving

Cautions



Information on adverse effects of propofol has been obtained principally from controlled clinical trials and worldwide postmarketing experience with the drug. The studies were conducted using various premedications, other anesthetic or sedative agents, and a range of lengths of surgical or diagnostic procedures. Most adverse effects were mild and transient. In adults, the adverse effect profile in patients undergoing monitored anesthesia care (MAC) sedation was similar to that of patients undergoing anesthesia, although more severe adverse respiratory effects (e.g., cough, upper airway obstruction, apnea, hypoventilation, dyspnea) were reported in those undergoing MAC sedation. In addition, the adverse effect profile in pediatric patients 6 days to 16 years of age undergoing anesthesia was similar to that of adults receiving propofol for anesthesia, although apnea may occur more frequently in children than in adults.
•Cardiovascular Effects

Propofol is a cardiovascular depressant with effects similar to or greater than those associated with other IV anesthetic induction agents. The main adverse cardiovascular effect of propofol during induction anesthesia is hypotension, with 30% or more decreases in both systolic and diastolic blood pressure. Concomitant use of propofol with an opiate agonist appears to increase the risk of severe hypotension. Administration of additional fluids and a cautious rate of IV infusion may help to prevent propofol-induced hypotension. Severe hypotensive effects may be alleviated by medical intervention. (See Cautions: Precautions and Contraindications.)

In clinical trials in patients undergoing anesthesia or MAC sedation, hypotension or arrhythmias (e.g., bradycardia, tachycardia) were reported in 3–10 or 1–3% of adults, respectively, while hypotension, hypertension, or arrhythmias (e.g., tachycardia) were reported in 17, 8, or 1.2–1.6% of pediatric patients undergoing anesthesia, respectively. In less than 1% of adults, ECG abnormalities, bigeminy, atrial arrhythmias, atrial premature complexes (APCs, PACs), ventricular premature complexes (VPCs, PVCs), and syncope, possibly associated with use of propofol, have been reported. Although a causal relationship to propofol has not been established, atrial fibrillation, atrioventricular (AV) heart block, bundle branch block, cardiac arrest, edema, extrasystole, hypertension, myocardial infarction, myocardial ischemia, ST-segment depression, supraventricular tachycardia, and ventricular fibrillation were reported in clinical trials in less than 1% of adults receiving propofol for anesthesia or MAC sedation.

In clinical trials in intubated, mechanically ventilated patients undergoing sedation with propofol in a critical care setting (e.g., an ICU), hypotension, bradycardia, and decreased cardiac output were reported in 26, 1–3, and 1–3% of patients, respectively. Although a causal relationship to propofol has not been established, arrhythmias (e.g., ventricular tachycardia), atrial fibrillation, bigeminy, cardiac arrest, extrasystole, and right-sided heart failure have been reported in less than 1% of adults receiving propofol for sedation in a critical care setting.

•Respiratory Effects

Propofol can depress respiration, and induction anesthesia frequently is associated with apnea. In clinical trials in 1573 adults receiving propofol for induction of anesthesia, duration of apnea was less than 30, 30–60, and more than 60 seconds in 7, 24, and 12% of patients, respectively. In addition, in clinical trials in 218 pediatric patients (neonates and children 16 years of age and younger) receiving 1- to 3.6-mg/kg doses of rapid IV propofol injections for induction of anesthesia, duration of apnea was less than 30, 30–60, and more than 60 seconds in 12, 10, and 5% of patients, respectively. Overall, apnea was reported in 1–3% of adult patients undergoing anesthesia or MAC sedation. The respiratory depressant effects of propofol appear to be similar to those of other IV induction anesthetics; however, the incidence and duration of apnea associated with propofol may be greater. During maintenance anesthesia, propofol may cause decreased ventilation, usually associated with increased carbon dioxide tension (PaCO2), the likelihood of which depends on the rate of administration of propofol and other concomitantly used drugs (e.g., opiates, sedatives).

In clinical trials, wheezing and cough, possibly associated with use of propofol, were reported in less than 1% of adults undergoing anesthesia or MAC sedation. Although a causal relationship to propofol has not been established, hypoxia, laryngospasm, bronchospasm, laryngismus, pulmonary edema, burning of the throat, dyspnea, hiccups, hyperventilation, hypoventilation, pharyngitis, sneezing, tachypnea, and upper airway obstruction were reported in less than 1% of adults receiving propofol for anesthesia or MAC sedation.

Although the respiratory depressant effects of propofol are not clinically important during mechanical ventilation, such effects may be important during the weaning process. Respiratory acidosis during weaning has been reported in 3–10% of adults undergoing sedation in a critical care setting. Decreased pulmonary function, possibly related to use of propofol, has been reported in less than 1% of adults undergoing sedation in a critical care setting, while hypoxia occurred in less than 1% of such adults; however, a causal relationship to the drug has not been established.

•Nervous System Effects

Involuntary movement has been reported in 3–10% of adults receiving propofol for anesthesia or MAC sedation, while this effect occurred in 17% of pediatric patients undergoing anesthesia. Hypertonia and/or dystonia, paresthesia, anticholinergic syndrome, agitation, chills, delirium, dizziness, and somnolence, possibly related to the use of propofol, have been reported in less than 1% of adults undergoing anesthesia or MAC sedation; in addition, abnormal dreams, increased sexual mood, anxiety, bucking/jerking/thrashing, confusion, shivering, clonic and/or myoclonic movement, asthenia, combativeness, confusion, depression, emotional lability, excitement, euphoria, fatigue, hallucinations, headache, hysteria, insomnia, moaning, neuropathy, opisthotonos, rigidity, seizures, somnolence, tremor, and twitching were reported in less than 1% of such adults, but causal relationship to propofol has not been established.

In less than 1% of adults undergoing sedation in a critical care setting, agitation, possibly related to the use of propofol, has been reported. In addition, chills and/or shivering, intracranial hypertension, seizures, somnolence, and abnormal thinking have been reported in less than 1% of such patients, although a causal relationship to propofol has not been established.

•Local Effects

Pain at the injection site occurs frequently (in up to 70% of patients) following peripheral IV administration of propofol. Pain at the injection site can be minimized in adults and children if the larger veins of the forearm or antecubital fossa rather than hand veins are used and by administering 1 mL of a 1% solution of IV lidocaine prior (30–120 seconds) to IV administration of propofol. For prevention of pain at the propofol injection site, other methods, including prior administration of opiates or metoclopramide, prior application of a tourniquet, topical nitroglycerin or a local anesthetic cream, or administration of propofol at low temperatures (4–5°C) also have been used. Intra-arterial injection in animals did not result in adverse local tissue effects and while pain was reported in patients who received inadvertent intra-arterial injection of propofol, there was no evidence of major sequelae. In animals, injection of propofol into subcutaneous or perivascular tissues was associated with minimal tissue reaction. Local pain, swelling, blisters and/or tissue necrosis has been reported rarely following inadvertent extravasation in postmarketing surveillance of propofol. The manufacturers state that in clinical trials, burning, stinging, or pain at the injection site was reported in 17.6% of adults undergoing anesthesia or MAC sedation and in 10% of pediatric patients. Phlebitis, thrombosis, and pruritus, possibly related to use of propofol, were reported in less than 1% of adults, while urticaria and/or pruritus and redness/discoloration were reported in less than 1% of such adults, but a causal relationship to the drug has not been established

see the percentages are low but still equipment to revive should be available .

 

[Ramona122003]

again I'm talking about very small doses given over a relatively short period of time , not high doses. we don't know what murray was doing , what amount he was giving




see the percentages are low but still equipment to revive should be available .

I understand that part, but I was referring to the statements given by the cook and the security. They claim Murray brought down oxygen tanks. I also think the police said there were tanks in the room.

To be fair, this could all be link to Michael's breathing problems and not the propofol, but it still make you wonder why Murray did not put a mask on him like what the instructions says if someone suffered from an overdose. If there really was oxygen tanks in the room, that is.

 

[bgz]

I was under the impression that everytime someone is anaesthetised they should be intubated? Every time I have been put under I've been intubated and can't think of anyone who hasn't been that I know...although I'm no expert. But yeah, to be intubated for 6 weeks or more...that would be a very sore throat. Makes you wonder what the hell Murray was doing.

I believe it's been said earlier by several members, but Propofol does not always require intubation, especially for short procedures like a colonoscopy, etc. I've had it and was not intubatged. But intubation and resuscitative equipment DOES need to be present. While it may be classified as an anesthetic, it doesn't exactly fall into the same catergory as something such as "inhaled" anesthetics PER SE. I use it virtually every day I work in a critical care setting. Frequently there is not a physician in the unit, much less an anesthesiologist, but they are "in house" and someone is always avaible. And there is always a crash cart with emergency meds and intubation equipment in the unit as well as patients being constantly monitored for b/p, O2 sat, hrt rate and resp rate, and alarms are always on and monitored at the central control panel as well as in each room.

With all that being said, nothing positive I can say about Murray by any stretch of the imagination. If the essential monitoring equipment was actually in use for Michael (with alarms enabled) and he had intubation equipment available, imo then it's still gross negligence at the minimum if he was not in the room or within earshot of the alarms; and if he did not call 911 immediately when he discovered Michael. As has been said before, the dispatchers could have been told the street name and the cross streets names and that it was Michael Jackson's home, surely someone in the dispatch/police dept could have determined the address somehow. And every physician is taught to intubate, nurses and respiratory therapists that are ACLS certified are taught to intubate, and if unable to intubate you resume manual hand/ambu bag ventilation. That is of course if the pt is capable of being resuscitated and it's not "too late".

:no:

 

[Soundmind]

I understand that part, but I was referring to the statements given by the cook and the security. They claim Murray brought down oxygen tanks. I also think the police said there were tanks in the room.

To be fair, this could all be link to Michael's breathing problems and not the propofol, but it still make you wonder why Murray did not put a mask on him like what the instructions says if someone suffered from an overdose. If there really was oxygen tanks in the room, that is.

the oxygen tanks came from tabloids after kai and the previous cook said they observed him with oxygen tanks. we don't know whether the police found any oxygen tanks in MJ's bedroom , certainly murray did not mention he gave mj oxygen , he claimed once he found him not breathing he performed CPR and gave him flumazenil . no mention of oxygen at all .

 

[Ramona122003]

the oxygen tanks came from tabloids after kai and the previous cook said they observed him with oxygen tanks. we don't know whether the police found any oxygen tanks in MJ's bedroom , certainly murray did not mention he gave mj oxygen , he claimed once he found him not breathing he performed CPR and gave him flumazenil . no mention of oxygen at all .

Thanks for clearing that up. So, it was all most likely tabloid trash about the oxygen tanks. Makes sense since we never heard about again.

However, every medication was noted in the warrant, so if oxygen tanks were not mentioned then they most likely were not there. Which makes Murray even more of an idiot. These oxygen tanks would had mostly be less expense to buy then the propofol and the benzos.

What the hell was Murray thinking? Even someone with no medical training knows to have a backup because things will go wrong. It is only a matter of when. Especially when you leave the freaking room.

 

[Soundmind]

I'm not saying he did not use oxygen tanks, you said the police mentioned they found oxygen tanks at mj's house, when infact the police never said that, this info came from tabloids . murray left nothing associated with propofol in that bedroom , certainly no oxygen tanks ,if indeed there were oxygen tanks in that room or at least murray left them for the police to find them he would have claimed he used oxygen to revive him , all he claimed was CPR nothing more nothing less .

 

[Soundmind]

also murray described how he administered everything that night in his interview with the police, step by step , he mentioned he was using an oximeter all the time but he never said there was oxygen given through a facial mask . He certainly would have mentioned them .
also in the search warrant we did not read anything about oximeter found at the house .

 

[StaceyMJ]

I believe it's been said earlier by several members, but Propofol does not always require intubation, especially for short procedures like a colonoscopy, etc. I've had it and was not intubatged. But intubation and resuscitative equipment DOES need to be present. While it may be classified as an anesthetic, it doesn't exactly fall into the same catergory as something such as "inhaled" anesthetics PER SE. I use it virtually every day I work in a critical care setting. Frequently there is not a physician in the unit, much less an anesthesiologist, but they are "in house" and someone is always avaible. And there is always a crash cart with emergency meds and intubation equipment in the unit as well as patients being constantly monitored for b/p, O2 sat, hrt rate and resp rate, and alarms are always on and monitored at the central control panel as well as in each room.

With all that being said, nothing positive I can say about Murray by any stretch of the imagination. If the essential monitoring equipment was actually in use for Michael (with alarms enabled) and he had intubation equipment available, imo then it's still gross negligence at the minimum if he was not in the room or within earshot of the alarms; and if he did not call 911 immediately when he discovered Michael. As has been said before, the dispatchers could have been told the street name and the cross streets names and that it was Michael Jackson's home, surely someone in the dispatch/police dept could have determined the address somehow. And every physician is taught to intubate, nurses and respiratory therapists that are ACLS certified are taught to intubate, and if unable to intubate you resume manual hand/ambu bag ventilation. That is of course if the pt is capable of being resuscitated and it's not "too late".

:no:

Thankyou for explaining, I understand it better now. :yes:

 

[Beachlover]

also murray described how he administered everything that night in his interview with the police, step by step , he mentioned he was using an oximeter all the time but he never said there was oxygen given through a facial mask . He certainly would have mentioned them .
also in the search warrant we did not read anything about oximeter found at the house .

Soundmind, I am impressed at your research and explanations. I had work today and just caught up. The Search Warrant is only going to mention the things that specifically pertain to the search in regards to what Murray said. They spoke for a long time and only a short summary was written so we don't know the whole story either.

Regarding the oxygen. Oxygen tanks were found in Neverland during that police raid. Pill bottles with various names on them were found too.

I don't know how to multi reference so I have to write several answers.

 

[Beachlover]

I did not go to med school but I do know enough to know when a doctor (or a medical professional) is talking out of his or her ass. my entire family is filled with doctors, I did pre-med in college, AND I've been in and out of hospitals and anesthesia enough times to know exactly what's kosher and what is not. as such, whether or not I know "enough" about Propofol is not as important as the fact that I know Murray is lying like there's no tomorrow, and there's no ifs, ands, or buts about it. the question is -- who's with him and what did he actually do that the coroner knows about.

Rude post. No comment.

 

[Beachlover]

I am not so sure. Michael also admitted that he had propofol before. So, why would Murray have to tell him that he was safe if he already taken it before and didn't die or suffer long-term effects. Also, if Michael hired him for the sole purpose of given him propofol, he didn't need Murray's blessings that it was safe, since he already hired him for that end.

As for Lee, I really cannot see why she would lie. She reported the propofol to the media before the LAPD. Before then, everyone was talking about painkillers and doctor shopping. Lee was the only person who stepped up and said this drug could be the thing that killed him and he was not shopping for drugs or doctors. Turns out everything she said was true.

So, even thought I have no clue about the phone call and that hot/cold feeling, Lee have so far proven to be telling the truth. She may had misinterpreted the situation, but I do not believe she would outright lie about it. Especially since I see no motive for he to lie about that detail.

Its actually very interesting that everything she said turned out to be true if you think about it. I mean.....she wasn't even involved for many months.

She certainly said everything the fans would want to hear. I find it particularly interesting that she was friends with someone within the home who was very close to Michael and she didn't want to say who it was (but of course if you paid attention, that person called her which they would know from phone records). Also, it was stated right in the search warrants that her records were not handed over right away.

Ramona, simply because someone died, I see every reason for someone to lie about something.

I'm not saying that she is, but did you ever get an uneasy feeling about something? She KNEW someone in that house.

 

[callmerose]

Its actually very interesting that everything she said turned out to be true if you think about it. I mean.....she wasn't even involved for many months.

She certainly said everything the fans would want to hear. I find it particularly interesting that she was friends with someone within the home who was very close to Michael and she didn't want to say who it was (but of course if you paid attention, that person called her which they would know from phone records). Also, it was stated right in the search warrants that her records were not handed over right away.

Ramona, simply because someone died, I see every reason for someone to lie about something.

I'm not saying that she is, but did you ever get an uneasy feeling about something? She KNEW someone in that house.

Who do you think she was friends with?

 

[Beachlover]

Who do you think she was friends with?

Alvarez.

Here is a quote from TMZ

"Two detectives from the LAPD Robbery Homicide Division conducted the interview, and the insider says, "Investigators were very impressed and thankful that neither men have spoken with the media, nor will they. There are no plans at this point for a follow-up interview, but if necessary, both will gladly comply. Alvarez and Amir's only interest was telling investigators what they knew."

Alvarez and Amir were there the day that Michael Jackson died. Alvarez was in the room with Michael Jackson and Dr. Conrad Murray in the crucial moments before the ambulance arrived."