Method - PROPOFOL -

[Suez]

Was this meant for me? I don't view a wheel filter as necessary for terminal use or propofol that looks ok and isn't expired.
Laser, that sounds much better.

No i wasnt thinking microbial infection. I thinking about propofol induced pain. Pain on injection of propofol is a well‐recognised problem with some people describing their pain as between moderate to severe pain following injection. Which is why the lidocaine mixture is used but i understand that flilters are becoming more popular. Microbiological filters i guess just provide a non‐pharmacological alternative to a lidocaine/propofol mixture for reducing injection pain.

No i wasnt thinking microbial infection. I thinking about propofol induced pain. Pain on injection of propofol is a well‐recognised problem with some people describing their pain as between moderate to severe pain following injection. Which is why the lidocaine mixture is used but i understand that flilters are becoming more popular. Microbiological filters i guess just provide a non‐pharmacological alternative to a lidocaine/propofol mixture for reducing injection pain.

I think i read earlier however, that you were talking about using a antecubital vein? Apparently this helps reduce Propofol induced pain compared to the back of the hand which is a popular choice amongst anaesthiologists, where pretreatment using lidocaine in conjunction with venous occlusion is used.

 

[Aap]

Discomfort from propofol isnt that bad. It stings, but it doesn't rise to the level of actively requiring remedy. Given the number of parts here, I'd put more concern at getting concentrations wrong Or uncertainty regarding source of the drugs introducing something that cracks the emulsion. I've found toradol to be significantly worse than propofol for discomfort.

 

[liverpoolfan]

I've thought about propofol but I can't have access to it at the moment. I'd definitely add it to my regimen if I had it.

In my part of the world alot of icu meds like midaz and propofol are unavailable for sale cos of the coronavirus outbreak causing the medicine factories in europe to shut down.. (as I was told, not sure if true)

Can't say for other parts of the world but in Thailand you could get alot of prescription meds over the counter.

I'm living in Thailand. Tell me more.

 

[laserfocus111]

@liverpoolfan I know of people who fly to Bangkok to buy stuff that's usually not sold over the counter such as hiv meds/antivirals/benzos and even chemo drugs without a prescription. Some of them regularly fly in to get cheaper non generic chronic meds.


I'm just wondering if a gravity dependent iv drip will stop working if the venous return stops or slows down during cardiac arrest. Will fluid from a drip still flow into the veins when it happens? In other words is there a possibility that the pressure from the drip set is equal to the intraluminal pressure of the vein caused by venous pooling from cardiac arrest? Perhaps it's time to make my own syringe pump.

I think the antecubital vein is a good choice for high flow as the lumen is much bigger and the site is more proximal to the heart. Should be able to wash whatever uncomfortable meds into your heart faster. I'm speaking as a layman of course.

 

[Aap]

This is why I mentioned blowing the veins. If you have a prominent great saphenous vein in your inner right thigh, you might consider using it (I'd put the local anesthetics in that one). Practically speaking, after you are in cardiac arrest, the question becomes moot. A syringe pump certainly can work, or you can get creative with a light weight to provide slight pressure to the gravity bags if concerned. 4key issues:
1. Achieving rapid unconsciousness
2. Ensuring unconsciousness is maintained
3. Ensuring adequate amounts of drugs delivered to achieve desired outcome
4. Ensuring vascular access/delivery not compromised until complete

these might help you frame your process so that you achieve what you are looking for.

 

[liverpoolfan]

@liverpoolfan I know of people who fly to Bangkok to buy stuff that's usually not sold over the counter such as hiv meds/antivirals/benzos and even chemo drugs without a prescription. Some of them regularly fly in to get cheaper non generic chronic meds.


I'm just wondering if a gravity dependent iv drip will stop working if the venous return stops or slows down during cardiac arrest. Will fluid from a drip still flow into the veins when it happens? In other words is there a possibility that the pressure from the drip set is equal to the intraluminal pressure of the vein caused by venous pooling from cardiac arrest? Perhaps it's time to make my own syringe pump.

I think the antecubital vein is a good choice for high flow as the lumen is much bigger and the site is more proximal to the heart. Should be able to wash whatever uncomfortable meds into your heart faster. I'm speaking as a layman of course.

Maybe I don't know the right pharmacies here in BKK but I have to go to Pattaya to get my benzos OTC. One very weird thing is that buying antibiotics OTC anywhere in Thailand is no problem at all - but try to buy aspirin and they act like you're trying to score H.

 

[Sunset Limited]

@liverpoolfan I know of people who fly to Bangkok to buy stuff that's usually not sold over the counter such as hiv meds/antivirals/benzos and even chemo drugs without a prescription. Some of them regularly fly in to get cheaper non generic chronic meds.


I'm just wondering if a gravity dependent iv drip will stop working if the venous return stops or slows down during cardiac arrest. Will fluid from a drip still flow into the veins when it happens? In other words is there a possibility that the pressure from the drip set is equal to the intraluminal pressure of the vein caused by venous pooling from cardiac arrest? Perhaps it's time to make my own syringe pump.

I think the antecubital vein is a good choice for high flow as the lumen is much bigger and the site is more proximal to the heart. Should be able to wash whatever uncomfortable meds into your heart faster. I'm speaking as a layman of course.

As AAP says, do not worry about propofol injection pain. The main problem is the stability of the propofol emulsion. During the development of Propofol Lipuro, a few of the subjects gave high pain scores in studies with Diprivan. It's around 30%. The risk of propofol pain in wide veins is very low.

If you have cardiac arrest, that mean you are dead right? Still if you can buy 1 more box of propofol, in my opinion do it. 600 mg bolus + 1400 mg infusion is much more reliable. 600 mg bolus dose is lethal by itself. Especially after 1 mg fentanyl.

 

[Suez]

Discomfort from propofol isnt that bad. It stings, but it doesn't rise to the level of actively requiring remedy. Given the number of parts here, I'd put more concern at getting concentrations wrong Or uncertainty regarding source of the drugs introducing something that cracks the emulsion. I've found toradol to be significantly worse than propofol for discomfort.

As AAP says, do not worry about propofol injection pain. The main problem is the stability of the propofol emulsion. During the development of Propofol Lipuro, a few of the subjects gave high pain scores in studies with Diprivan. It's around 30%. The risk of propofol pain in wide veins is very low.

If you have cardiac arrest, that mean you are dead right? Still if you can buy 1 more box of propofol, in my opinion do it. 600 mg bolus + 1400 mg infusion is much more reliable. 600 mg bolus dose is lethal by itself. Especially after 1 mg fentanyl.

I agree the emulsion is definately the main issue. It occured to me too that using the antecubital vein makes pain less of an issue too.

 

[laserfocus111]

This is why I mentioned blowing the veins. If you have a prominent great saphenous vein in your inner right thigh, you might consider using it (I'd put the local anesthetics in that one). Practically speaking, after you are in cardiac arrest, the question becomes moot. A syringe pump certainly can work, or you can get creative with a light weight to provide slight pressure to the gravity bags if concerned. 4key issues:
1. Achieving rapid unconsciousness
2. Ensuring unconsciousness is maintained
3. Ensuring adequate amounts of drugs delivered to achieve desired outcome
4. Ensuring vascular access/delivery not compromised until complete

these might help you frame your process so that you achieve what you are looking for.

Indeed, your 4 points are spot on.

I can only ensure 1 and 2 with a gravity dependent iv drip system.

I was hesitant with putting a plug into the great saphenous cos it might be cumbersome. I will have to sit up on my bed, reach to all 3 clamps and release, than quickly bolus the 20cc proprofol into the most proximal vein and hopefully not mess anything up.

@ThatsEnoughForMe

Cardiac arrest doesn't mean death just yet. It just means the heart stops pumping out blood during that period of time. I'm hoping the dosage entering my system is enough to make the cardiac arrest long enough for death to occur.

I didn't want to attract too much attention so I am getting one box first. It should arrive soon. I am thinking if I get found out by my family and they start doing CPR and the necessary interventions (adrenaline etc since they work in the relevant fields) they might be able to prolong my circulation long enough start me on some ECMO.

 

[Aap]

The whole point about cardiac arrest is your heart isn't pumping or pumping inefficiently. All the f in the world in your venous system matters not if it can't circulate to your brain. That is the point of ensuring you aren't conscious when you experience cardiac arrest. If you enter sudden cardiac arrest due to a massive dose of local anesthetics, you very likely will not leave it without intervention.

With the propranol,you have enough to be fatal several times over.

 

[laserfocus111]

The whole point about cardiac arrest is your heart isn't pumping or pumping inefficiently. All the f in the world in your venous system matters not if it can't circulate to your brain. That is the point of ensuring you aren't conscious when you experience cardiac arrest. If you enter sudden cardiac arrest due to a massive dose of local anesthetics, you very likely will not leave it without intervention.

Hence there is not much of a choice with the location of the plug for the lignocaine/bupivacaine if I am looking to increase my odds of success.

Thank you for the advice! Much appreciated.

 

[laserfocus111]

Finally it arrived. It will be soon.

 

[laserfocus111]

Hi guys, I'm still around. Maybe not for much longer. I don't know.

I've come across a journal article about a 29 year old anesthesiologist who CTB with 1g of propofol, 0.5mg fentanyl, atracurium 50mg and lignocaine 40mg (presumably to reduce the pain from propofol). This is of course assuming that the ampoules he left behind at the scene are indicative of the actual dose administered. Putting this recipe up for reference.

Might be a good idea for me to start looking for some atracurium..

 

[Aap]

It's not needed and is intended to paralyze and stop breathing. My maths say that is 1g of fentanyl. The lidocaine was habit to prevent burning from propofol. He treated this like an anesthesia induction with higher amounts of propofol and fentanyl used.

 

[laserfocus111]

sorry it's 1 mg of fentanyl. my bad.

 

[Euthanza]

If you can get ethomidate and thiopental it will be even more lethal I think. I'll look into this when I have the time.

No. Propofol is two times stronger than Thiopental, a fatal dose 1gram vs 2gram is used in Spain and Canada euthanasia protocol

 

[ksp]

peacefulness of propofol

Guy knocks himself out with propofol for surgery