Two statements in the article by Lau et al. (1) concern us. In the abstract, it reads, “Inadequate analgesia was treated with IV propofol,” while in Methods, they state, “If mild discomfort was observed…IV propofol in 10–20 mg increments was administered as necessary.”
It has to be assumed that the authors believe that propofol is an analgesic. This would be a belief that we have to contest. Although propofol is a good sedative and amnestic drug, it does not have analgesic properties.
Too often, in our opinion, patients receive propofol, at a time when an analgesic would serve them better. Many times, our surgical colleagues insist that propofol, or “that white stuff,” “works much better.” They seem to believe that propofol is a miracle drug, without side effects, and appropriate for every patient in every circumstance. They seem to think propofol can replace adequate analgesia obtained by infiltration with local anesthesia. Unfortunately, educating them is sometimes difficult. However, this prestigious journal should certainly provide our fellow anesthesia providers with correct information regarding appropriate use of certain drugs, including the effects they do not exert.
In short, we feel that an article rendering the impression described above may lead to incorrect assumptions and use.
Menno F. TerRiet MD
Jeffrey S. Jacobs MD
Michael C. Lewis MD
Gerard J. A. DeSouza MD
1. Lau WC, Green CR, Faerber GJ, et al. Determination of the effective therapeutic dose of intrathecal sufentanil for extracorporeal shock wave lithotripsy. Anesth Analg 1999; 89:889–92.