Summary of evidence and Expert Committee recommendations
Propofol was added to the core list of the EML and EMLc in 2011.
The Committee acknowledged that there is high-quality evidence to support the safety and efficacy of propofol as an IV anaesthetic and that there are also potential cost benefits when used for day case surgery compared to thiopental. The Committee concluded that in settings where resources are sufficient to support a range of surgical services, including day case surgery, propofol is probably cost effective, although thiopental also needs to be available for certain indications. However in settings where surgical services and resources are limited, the IV anaesthetic of choice should be the one that is safe, effective, and can be used for the greatest number of indications, i.e. thiopental. The Committee noted increasing problems with availability of thiopental in some settings. The Committee recommended the addition of propofol to the Model List, and decided to list thiopental as an alternative, based on programmatic considerations (availability and cost).