Why sedate with propofol, only to use General anaesthesia later?

[letsfixthis]

During my shoulder surgery, I was told that they use propofol to put me under, then use General anaesthesia to keep me under.

My question is why not just use propofol for the entire operation or if they were going to use  General anaesthesia, why not use that from the beginning. Why start with propofol (twilight sedation) before moving to general?

Thanks.

[George Pope, M.D.]

Propofol is rapid in onset and goes away quickly.  It is typically used for induction or putting someone to sleep because it is rapid and you get good relaxation for ease of intubation or tube placement.  Patients can be controlled on a propofol drip, but an inhalation agent (gas) mixed with oxygen is used more commonly, usually for longer procedures.  Propofol is often used alone in quick procedures like colonoscopies.  The reason the inhalational agents aren't used to put people to sleep initially is that many of them are a little irritating to the awake patient.  That is, breathing in the gas while awake would be bothersome because it may smell bad or irritating.  There are exceptions to that, such as some gases used in children.  It all gets complex, and I'm not an anesthesiologist, so I shouldn't carry this further.  Hope this answers your question.

Dr. Pope, MD

[Dr. Elliot Jacobs]

Dr. Pope is absolutely correct.

One thing to understand -- Propofol will put you to sleep very quickly -- but it does not control pain in any way.  therefore the surgeon needs to inject local anesthetic as well.

During general anesthesia, you are unconscious and the anesthetic not only puts you to sleep but it makes the surgery pain free.

Dr Jacobs

[letsfixthis]

Two very good answers. Thank you both.

I think in my case, I was given Versed to relax/put me to sleep for the Propofol which was to put me to sleep for the Laryngeal Mask Airway with the general Anestesia.

I don't remember anything past the versed however I was told that I was awake and talking to people in the operating room before the Propofol was administered.(I hope I did not say anything offensive)

I did not know that Propofol had no pain stopping properties. So you would never use this on a major surgery correct? Only a relatively minor procedure which you could use a local anesthesia to numb the area first?

Very valuable information. Thank you. I feel like I understand this a lot better now.