Propofol is in the air: can exhaled gas monitoring illuminate intravenous dosing?

Exhaled propofol monitoring has the potential to guide i.v. anaesthesia in a manner analogous to end-tidal monitoring of inhalation anaesthetics. Early proof-of-concept studies demonstrated the detection of propofol in breath, but adoption into routine clinical practice has been limited by the lack of compact, accurate, and rapid sensors, together with incomplete understanding of the pharmacokinetics of exhaled propofol across diverse patient populations. In this issue, a novel photoacoustic sensor that demonstrates strong correlation with mass spectrometry, the current gold standard for exhaled propofol detection, while offering reduced complexity and size, is described. This technology could facilitate broader investigation of exhaled propofol in clinical settings, potentially informing strategies to improve anaesthesia delivery and patient outcomes during i.v. anaesthesia.