Anesthesia Monitoring

About Propofol Monitoring

Xhale is developing a breath-based propofol monitor for use in the operating room, intensive care unit and in outpatient settings. Propofol usage has grown in the past few years into one of the most commonly-used intravenous drugs employed to induce and maintain general anesthesia. The anesthetic’s popularity is due to several factors, including the pleasant mental state patients’ experience, the drug’s rapid onset and short duration of action, shortened waking and recovery times for the patient and a reduced need for opioids, resulting in less nausea and vomiting.

But propofol has serious safety issues. Propofol can be unpredictable in untrained hands, as dosing and titration is variable and is based on the patient’s response and tolerance to the drug, which varies widely. Respiration can change dramatically in a very short time, deteriorating to full respiratory arrest, even when propofol is given in low doses. Individual responses to propofol cannot be absolutely predicted, and the administering healthcare professional must be solely devoted to the patient’s sedation, not busy doing other tasks related to a medical procedure such as endoscopy. In 2001 the FDA issued a safety warning related to propofol in pediatric ICU patients.

There is no way today for an anesthesiologist to determine the ongoing blood level of propofol in a patient. Patient depth of anesthesia and ventilatory adequacy is monitored by a combination of monitoring blood pressure, pulse, respiratory rate, oxygen saturation (with a pulse oximeter) and end-tidal carbon dioxide (with a capnograph). Xhale's propofol monitor will offer the ability to monitor propofol concentration in plasma via the exhaled breath, giving the anesthesiologist better feedback for titration of propofol.