Expert: Ronald Levy, M.D. - 3/27/2011

Question
My question is regarding the pain that might be felt if only Propofol is used during surgery. I am having surgery to reconstruct my nasal bones following an accident. I have asked my physician about the anesthesia he plans to use. He said he always uses IV Propofol with an air pillow. I approve of this because I don't want inhalational anesthesia (some evidence of causing more beta-amyloid plaque deposition), but I am also aware that it is not an analgesic, only an anesthetic. Though I know I will not have any memory of the pain, I will still feel pain, right?
I am pretty sure no local anesthetic will be used. Epinephrine will be used to constrict the blood vessels.  

Should I ask my surgeon to add an opioid or something else?

Answer
First of all, if he is using Propofol as an anesthetic and not a sedative, you will not feel pain because you will be under anesthesia. If he is giving epinephrine for vasoconstriction, he almost certainly will be giving that as part of a local anesthetic. Second, I don't know where you read about amyloid plaque deposition but I have never heard of that and certainly not with such a short procedure. If you are reading on the internet, check your sources. Most of the stuff there is not peer-reviewed. Third, I am sure your surgeon will also give some analgesics (e.g. narcotics). You don't need to specify that.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston