SAGE Anesthesiologist talks about how
we use this drug in veterinary medicine

John “Iain” Glen grew up on a farm in Scotland, and he always enjoyed working with animals.[1]

Flash forward about 50 years. In September 2018, Dr. Glen, a British veterinarian and veterinary anesthesiologist, won the prestigious Albert and Mary Lasker Foundation Award for the development of propofol, a drug used in human and veterinary medicine to induce anesthesia. We at SAGE Veterinary Centers were pleased to hear that a veterinarian was behind the development of a drug that is so effective at blocking the conscious sensation of pain. We checked in with SAGE Anesthesiologist Kris Kruse-Elliott, DVM, Ph.D., DACVAA, to learn more about how this drug is used in veterinary medicine.

Q: A quick Google search reveals that propofol was developed in 1977 but was not approved for use in the United States until 1989.[2] Why did it take so long to catch on in the states?

A: The initial challenge with propofol was finding a formulation that was safe for intravenous administration and allowed the drug to be delivered to the brain via the bloodstream. Chemists were able to develop a soybean-based emulsion that was safe to use and then approval in the UK and the US followed fairly quickly.

 

Q: What makes propofol an effective drug for use in veterinary medicine?

A: Propofol works well to induce initial, general anesthesia in a wide variety of species, especially dogs and cats. It takes effect very quickly, and it also clears the liver very quickly, which enables patients to recover rapidly from anesthesia. Propofol does not accumulate significantly in a patient’s body, so veterinarians can deliver a constant amount of the drug to maintain anesthesia in situations where inhalant anesthetics are recommended.

                                                  

Q: Are there cases where you would not opt for propofol, and choose another anesthetic drug instead?

A: Propofol may not always be the best choice to induce anesthesia in patients that are compromised by cardiovascular dysfunction. Alternatively, with adequate additional premedication, we will often still use propofol, but at a much lower dose to better maintain cardiovascular function.  Also, if we have a patient with a known allergy to the soybean-based emulsion, we avoid propofol. Beyond that, it’s really about how you monitor the patient during and after anesthesia.  Good anesthesia monitoring has much more impact than whether or not you use propofol as part of your protocol.

 

Sources:

[1] Science. http://www.sciencemag.org/news/2018/09/if-you-ve-had-anesthesia-you-can-likely-thank-veterinarian-who-just-won-top-science Retrieved Oct. 12, 2018.

[2] Wikipedia. https://en.wikipedia.org/wiki/Propofol Retrieved Oct. 12, 1989.