Clinical Use Overview

Propofol (2,6-diisopropylphenol, C₁₂H₁₈O, M.W. 178.27, Vapor Pressure 0.142 mmHg @ 20° C) is an extremely popular intravenous general anesthetic agent due to several favorable characteristics , including: an anti-emetic effect, rapid emergence from unconsciousness with minimal residual drowsiness, and a general state of euphoria.^1-4 Consequently, propofol has become the most frequently administered intravenous hypnotic currently used in modern anesthetic practice and is available in a number of branded and generic forms.

Recently, three independent research groups located in Germany, Austria, and Japan demonstrated that propofol appears in human exhaled breath following intravenous administration and that the concentrations relate to the blood concentrations.^5-7 The use of an exhaled breath propofol monitor in a clinical environment is now feasible from a biological standpoint.

Real-time, frequent, point-of-care, measurement of propofol concentrations in exhaled breath would enable clinicians to provide better care of their patients and add to the number of gasses and anesthetics already measured in breath. In the hospital and ambulatory setting, propofol and its detection in breath would be used in three primary areas: intraoperative anesthesia, acute sedation during minor procedures, and longer term sedation in the intensive care unit.

References

1. Chhabra A, Pandey R, Khandelwal M, Subramaniam R, Gupta S: Anesthetic techniques and postoperative emesis in pediatric strabismus surgery. Reg Anesth.Pain Med. 2005; 30: 43-7

2. Song D, Whitten CW, White PF, Yu SY, Zarate E: Antiemetic activity of propofol after sevoflurane and desflurane anesthesia for outpatient laparoscopic cholecystectomy. Anesthesiology 1998; 89: 838-43

3. Jellish WS, Leonetti JP, Murdoch JR, Fowles S: Propofol-based anesthesia as compared with standard anesthetic techniques for middle ear surgery. J.Clin.Anesth. 1995; 7: 292-6

4. Chan VW, Chung FF: Propofol infusion for induction and maintenance of anesthesia in elderly patients: recovery and hemodynamic profiles. J.Clin.Anesth. 1996; 8: 317-23

5. Hornuss C, Praun S, Villinger J, Dornauer A, Moehnle P, Dolch M, Weninger E, Chouker A, Feil C, Briegel J, Thiel M, Schelling G: Real-time monitoring of propofol in expired air in humans undergoing total intravenous anesthesia. Anesthesiology 2007; 106: 665-74

6. Kharasch ED: Every breath you take, we'll be watching you. Anesthesiology 2007; 106: 652-4

7. Takita A, Masui K, Kazama T: On-line monitoring of end-tidal propofol concentration in anesthetized patients. Anesthesiology 2007; 106: 659-64