The manslaughter trial of Michael Jackson’s personal physician, Dr. Conrad Murray, focused a lot of attention on a powerful anesthetic agent called propofol. Propofol is sometimes called the “milk of anesthesia” because it comes in a white, oily solution. Propofol is used as an induction agent—the drug that causes loss of consciousness— for general anesthesia in major surgery. Propofol is also a very good anesthetic for milder sedation used for outpatient surgery because it puts people in a semi-conscious, drowsy state. It starts acting quickly, but also wears off quickly. Like many sedating anesthetics, propofol lowers blood pressure and suppresses breathing, so the heart function and breathing of patients need to be constantly monitored. With a lot of propofol around, opportunities exist for abuse, with possibly fatal consequences.
Although current recommendations call for pediatricians to ask their adolescent patients about alcohol and drug use at every visit, many don’t. To make it easier for doctors and nurses to do this, the American Academy of Pediatrics has just published a set of questions to guide the confidential conversation, along with advice on what to do with the answers. The first question is a simple one about drug or alcohol use. If the answer is no, the health care provider should praise the teen and encourage him or her to continue making good decisions about health and safety. If the answer is yes, six follow-up questions called the CRAFFT questions) can help separate those who are experimenting from those who may be headed for serious trouble and need more in-depth help.
Smokers who want to quit can turn to a nicotine replacement products, prescription medications, and counseling. What about the newest stop-smoking aid, the electronic cigarette? Despite its appeal, we don’t know enough about the safety or effectiveness of electronic cigarettes to give them the green light. Preliminary studies from the FDA, New Zealand, and Greece raise some concerns about the dose of nicotine delivered and potentially harmful chemicals that might be in the vapor. Until good studies have been done on electronic cigarettes, the best way to quit involves using nicotine replacement or a medication along with some sort of counseling or support, either in person, by telephone, or even by text message.
Teenagers and young adults who use marijuana may be messing with their heads in ways they don’t intend. Ongoing research shows a possible link between early use of marijuana and later development of psychosis or schizophrenia.
On October 16, 1846, Dr. John Collins Warren, a renowned surgeon at Massachusetts General Hospital, removed a tumor from a printer named Gilbert Abbott. The operation was noteworthy for one reason: Abbott did not scream out in pain, as virtually every surgical patient did in those days. The age of anesthesia was born. A Boston [...]