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Death by Propofol.

James H Diaz1, Alan David Kaye2

  • 1School of Public Health - Louisiana State University Health Sciences Center - New Orleans, LA.

The Journal of the Louisiana State Medical Society : Official Organ of the Louisiana State Medical Society
|April 18, 2017
PubMed
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Propofol, a widely used anesthetic, has a significant abuse potential leading to fatalities, especially among healthcare workers. Accidental deaths are more common than suicides or homicides, with higher blood levels in intentional cases.

Area of Science:

  • Anesthesiology
  • Pharmacology
  • Toxicology

Background:

  • Propofol (2,6-diisopropylphenol) is a widely used intravenous sedative-hypnotic agent for anesthesia and sedation.
  • Despite its therapeutic benefits, propofol has a notable potential for abuse, highlighted by high-profile cases.
  • The lack of regulation as a controlled substance has contributed to its abuse.

Purpose of the Study:

  • To investigate the epidemiological characteristics of fatal propofol abuse.
  • To analyze the circumstances and demographics associated with propofol-related deaths.

Main Methods:

  • A descriptive analysis of scientific literature was performed using internet search engines.
  • Fatal propofol abuse cases were identified and stratified into unintentional (accidental) and intentional (suicide, homicide) deaths.

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  • Continuous variables were compared using unpaired, two-tailed t-tests with statistical significance set at p < 0.05.

    • Main Results:

    • Out of 21 identified fatal cases, 86% occurred in healthcare workers, predominantly anesthesiologists and nurse anesthetists.
    • The majority of deaths (81%) were accidental, with two suicides and two homicides.
    • Blood propofol levels were significantly higher in intentional deaths compared to accidental ones (p < 0.0001).

    Conclusions:

    • Propofol abuse presents a significant risk, particularly among young healthcare professionals in operating room settings.
    • The abuse of propofol is likely underreported and associated with a high fatality rate.
    • Propofol is a dangerous drug with evident abuse potential leading to fatal outcomes.