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Thursday, August 27, 2009

Quantcast Propofol dosage reported in Michael Jackson case is low, experts say


If Michael Jackson died from lethal levels of the powerful anesthetic propofol, then he must have been injected with much more of the drug than his personal physician reportedly told police he gave the pop star, medical experts said.

According to court records unsealed in Houston on Monday, Dr. Conrad Murray told police that he had been giving Jackson 50 milligrams of propofol each night over a six-week period. In a three-hour interview with police two days after Jackson's death, Murray said he had been trying to wean the singer off the powerful anesthetic and, on the night of his death, gave him a combination of other sedatives before succumbing to Jackson's repeated demands for propofol.

Murray then gave Jackson 25 milligrams of propofol, according to the documents, which were filed with the court in support of searches of Murray's office and storage unit in Houston. But those amounts -- 25 and 50 milligrams -- are far below the dosage required to anesthetize someone and keep them asleep, several experts said.

"It doesn't make any sense," said Dr. John Dombrowski, a member of the American Society of Anesthesiologists. "I cannot believe that was the number that was given. Such a small amount won't tip anyone over in terms of respiratory depression."

What's more likely, Dombrowski said, is that the numbers in the documents are somehow in error. Murray might not have provided an infusion rate, such as 25 milligrams every few minutes, or police might not have understood the medical terminology, Dombrowski said.

The preliminary toxicology reports cited in the court records said that "lethal levels" of propofol were found in Jackson's blood. Final autopsy and toxicology reports have yet to be released by the Los Angeles County coroner's office.

Murray has said through his attorney that he believes nothing he administered should have led to Jackson's death. His attorney, Ed Chernoff, said Murray answered the detectives' questions truthfully.

In a YouTube video, a direct message from Murray to his supporters, the doctor thanked people for standing by him. "I have done all I could do," Murray said in the video. "I told the truth, and I have faith the truth will prevail."

The medical experts said that if the propofol dosage were higher and combined with other medications, it could have led to an overdose.

Dr. Scott Engwall, vice chair of anesthesiology at UC Irvine's School of Medicine, said that for an average person without a high tolerance to drugs, 50 milligrams of propofol might be enough to make them doze off for five or 10 minutes. But the drug would immediately wear off. Someone like Jackson, who had been using it nightly for as many as six weeks, according to Murray's testimony, might close his eyes briefly -- or it might not work at all, Engwall and other doctors said.

"I think it's not unreasonable that there is some part of this picture we still do not know," Engwall said.

For Further Information you can contact the writer on kimi.yoshino@latimes.com
Times reporter Harriet Ryan contributed to this report.

Source : Los Angeles Times

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