Propofol and Analgesia

We greatly appreciate the interest of Dr. TerRiet et al., who was not among the first to question our statement, “inadequate analgesia was treated with IV propofol,” and “mild discomfort was supplemented with 10–20 μg of incremental propofol” in our article. In regard to the second paragraph, “the authors believe that propofol is an analgesic…, it does not have analgesic properties.” We agree that propofol is not an analgesic, but many studies have certainly demonstrated analgesic properties of propofol (1–4). I invite Dr. TerRiet to review these articles. There is also strong evidence that propofol interacts with polysynaptic excitation by decreasing the release of excitatory neurotransmitters, e.g., l-glutamate and l-aspartate (5). We believe that, because of these well documented analgesic properties of propofol, it provided an excellent supplementation to intrathecal sufentanil for patients undergoing outpatient extracorporeal shock-wave lithotripsy. Concerning the statement about our surgical colleagues, I agree we need to educate them, but we should educate them based on scientific facts and findings, not on personal bias. Finally, because of prestigious journals like this, we can enhance our knowledge and heighten our awareness of current controversies in anesthesiology, and in turn, we can properly teach our fellow anesthesiologists. In summary, we did not feel that the statements in our article were incorrect, because it was written with well documented facts from previous studies. Wei C. Lau MD Carmen R. Green MD Gary Faerber MD Alan R. Tait PhD Julie A. Golembiewski PharmD