Recent positron emission tomography studies have indicated different neural networks subserving various types of memory and attention. Another reason to distinguish sedative from amnesic effects is the recent availability of neuroimaging techniques that can define functional neuroanatomy. To clearly define the amnesic effect of any drug, we must control for its sedative effects. It is unclear how much the sedative effects of propofol contribute to its clinically apparent amnesic effects. Sedation itself can produce “amnesia” due to inattention to the stimuli presented for later recall. Because of its short context-sensitive half-life, propofol can be administered to produce profound sedation while still permitting rapid recovery. This perception may be based on some anecdotal reports of awareness during propofol anesthesia (for example, see Kelly and Roy and Rupreht ).
Although the literature indicates that propofol has substantial amnesic effects, a common clinical perception is that propofol may not be a good amnesic agent. The benzodiazepines and propofol are used because of their intense amnesic effects. Ideally, amnesia can occur while the patient is still awake and cooperative. One of the most common uses of intravenous sedative agents today is to produce amnesia during minor surgical procedures.
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