Expert: JM Starkman, MD - 11/29/2010

Question
I've had three past experiences with propofol during the past 5 years.  On two occasions it was used for a brief period during the administration of local anesthesia.  It worked well for this purpose, leaving me mildly euphoric both times.  The third time it was used during a 45-minute procedure.  I woke up in a "manic" state--highly euphoric and extremely irritable.  My amnesia for the procedure left me feeling enraged and "violated".  (Yes, I'm aware of the total irrationality of this reaction, but this insight doesn't change my emotions associated with the experience.)  Fortunately, my behavior at the surgery center was not outwardly bizarre, although I had bad memories associated with the experience for several weeks.   I'm scheduled to have another surgery using MAC in a couple of weeks.  How likely is it that I'll have a similar reaction to propofol?  I'm very hesitant to raise my concerns with my anesthesia provider, since I absolutely don't want to substitute general anesthesia for MAC.

Answer
Don't be hesitant to raise concerns with your anesthesia "provider"...maybe he or she could help resolve the matter....especially since it's his JOB to do so!  And don't forget that simply because you had a propofol anesthetic, that other agents such as fentanyl or midazolam were not added to the 'mix' as adjuncts to pain or memory issues.

Here's a novel idea:  Since you're asking this anesthesiologist's opinion of the matter, and it involves YOUR health, why don't you ask the question of a board certified anesthesiologist (instead of an "anesthesia provider") at the hospital or surgery center where you're having your surgery?