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Muller-Wirtz, L. M., Maurer, F., Brausch, T., Kiefer, D., Floss, M., Doneit, J., Volk, T., Sessler, D. I., Fink, T., Lehr, T., Kreuer, S. Exhaled propofol concentrations correlate with plasma and brain tissue concentrations in rats. Anesth Analg 2021: 132 (1) 110-118

October 16, 2021

BACKGROUND: Propofol can be measured in exhaled gas. Exhaled and plasma propofol concentrations correlate well, but the relationship with tissue concentrations remains unknown. We thus evaluated the relationship between exhaled, plasma, and various tissue propofol concentrations. Because the drug acts in the brain, we focused on the relationship between exhaled and brain tissue propofol concentrations.
METHODS: Thirty-six male Sprague-Dawley rats were anesthetized with propofol, ketamine, and rocuronium for 6 hours. Animals were randomly assigned to propofol infusions at 20, 40, or 60 mg·kg−1·h−1 (n = 12 per group). Exhaled propofol concentrations were measured at 15-minute intervals by multicapillary column–ion mobility spectrometry. Arterial blood samples, 110 µL each, were collected 15, 30, and 45 minutes, and 1, 2, 4, and 6 hours after the propofol infusion started. Propofol concentrations were measured in brain, lung, liver, kidney, muscle, and fat tissue after 6 hours. The last exhaled and plasma concentrations were used for linear regression analyses with tissue concentrations.
RESULTS: The correlation of exhaled versus plasma concentrations (R2 = 0.71) was comparable to the correlation of exhaled versus brain tissue concentrations (R2 = 0.75) at the end of the study. In contrast, correlations between plasma and lung and between lung and exhaled propofol concentrations were poor. Less than a part-per-thousand of propofol was exhaled over 6 hours.
CONCLUSIONS: Exhaled propofol concentrations correlate reasonably well with brain tissue and plasma concentrations in rats, and may thus be useful to estimate anesthetic drug effect. The equilibration between plasma propofol and exhaled gas is apparently independent of lung tissue concentration. Only a tiny fraction of administered propofol is eliminated via the lungs, and exhaled quantities thus have negligible influence on plasma concentrations. (Anesth Analg 2021;132:110–8)