An integrated microcatheter-based dual-analyte sensor system for simultaneous, real-time measurement of propofol and fentanyl

Smart Hydrogel Swelling State Detection Based on a Power-Transfer Transduction Principle

Stimulus-responsive (smart) hydrogels are a promising sensing material for biomedical contexts due to their reversible swelling change in response to target analytes. The design of application-specific sensors that utilize this behavior requires the development of suitable transduction concepts. The presented study investigates a power-transfer-based readout approach that is sensitive to small volumetric changes of the smart hydrogel. The concept employs two thin film polyimide substrates with embedded conductive strip lines, which are shielded from each other except at the tip region, where the smart hydrogel is sandwiched in between. The hydrogel's volume change in response to a target analyte alters the distance and orientation of the thin films, affecting the amount of transferred power between the two transducer parts and, consequently, the measured sensor output voltage. With proper calibration, the output signal can be used to determine the swelling change of the hydrogel and, consequently, to quantify the stimulus. In proof-of-principle experiments with glucose- and pH-sensitive smart hydrogels, high sensitivity to small analyte concentration changes was found along with very good reproducibility and stability. The concept was tested with two exemplary hydrogels, but the transduction principle in general is independent of the specific hydrogel material, as long as it exhibits a stimulus-dependent volume change. The application vision of the presented research is to integrate in situ blood analyte monitoring capabilities into standard (micro)catheters. The developed sensor is designed to fit into a catheter without obstructing its normal use and, therefore, offers great potential for providing a universally applicable transducer platform for smart catheter-based sensing.

Electrochemical Determination of Fentanyl Using Carbon Nanofiber-Modified Electrodes

In this work, we report the direct electrochemical oxidation of fentanyl using commercial screen-printed carbon electrodes (SPCEs) modified with carboxyl-functionalized carbon nanofibers (fCNFs). CNFs have surface chemistry and reactivity similar to carbon nanotubes (CNTs), yet they are easier to produce and are of a lower cost than CNTs. By monitoring the current produced during the electrochemical oxidation of fentanyl, variables such as fCNF loading, fentanyl accumulation time, electrolyte pH, and differential pulse voltammetry parameters were optimized. Under an optimized set of conditions, the fCNF/SPCEs responded linearly to fentanyl in the concentration range of 0.125-10 μM, with a limit of detection of 75 nM. The fCNF/SPCEs also demonstrated excellent selectivity against common cutting agents found in illicit drugs (e.g., glucose, sucrose, caffeine, acetaminophen, and theophylline) and interferents found in biological samples (e.g., ascorbic acid, NaCl, urea, creatinine, and uric acid). The performance of the sensor was also successfully tested using fentanyl spiked into an artificial urine sample. The straightforward electrode assembly process, low cost, ease of use, and rapid response make the fCNF/SPCEs prime candidates for the detection of fentanyl in both physiological samples and street drugs.

Nanoencapsulation of general anaesthetics

General anaesthetics are routinely used to sedate patients during prolonged surgeries and administered via intravenous injection and/or inhalation. All anaesthetics have short half-lives, hence the need for their continuous administration. This causes several side effects such as pain, vomiting, nausea, bradycardia, and on rare occasions death post-administration. Several clinical trials studied the synergetic effect of a combination of anaesthetic drugs to reduce the drug load. Another solution is to encapsulate anaesthetics in nanoparticles to reduce their dose and side effects as well as achieve their sustained release manner. Different types of nanoparticles were developed as carriers of intravenous and intrathecal anaesthetics generating platforms which facilitate drug transport across the blood-brain barrier (BBB). Nanocarriers encapsulating common anaesthetic drugs such as propofol, etomidate, and ketamine were developed and characterized in terms of size, stability, onset and duration of loss of right reflex, and tolerance to pain in small animal models. The review discusses the types of nanocarriers used to reduce the side effects of the anaesthetic drugs while prolonging the sedation time. More rigorous studies are still required to evaluate the nanocarrier formulations regarding their ability to deliver anaesthetic drugs across the BBB, safety, and finally applicability in clinical settings.

Anesthesia Patient Monitoring 2050

The monitoring of vital signs in patients undergoing anesthesia began with the very first case of anesthesia and has evolved alongside the development of anesthesiology ever since. Patient monitoring started out as a manually performed, intermittent, and qualitative assessment of the patient's general well-being in the operating room. In its evolution, patient monitoring development has responded to the clinical need, for example, when critical incident studies in the 1980s found that many anesthesia adverse events could be prevented by improved monitoring, especially respiratory monitoring. It also facilitated and perhaps even enabled increasingly complex surgeries in increasingly higher-risk patients. For example, it would be very challenging to perform and provide anesthesia care during some of the very complex cardiovascular surgeries that are almost routine today without being able to simultaneously and reliably monitor multiple pressures in a variety of places in the circulatory system. Of course, anesthesia patient monitoring itself is enabled by technological developments in the world outside of the operating room. Throughout its history, anesthesia patient monitoring has taken advantage of advancements in material science (when nonthrombogenic polymers allowed the design of intravascular catheters, for example), in electronics and transducers, in computers, in displays, in information technology, and so forth. Slower product life cycles in medical devices mean that by carefully observing technologies such as consumer electronics, including user interfaces, it is possible to peek ahead and estimate with confidence the foundational technologies that will be used by patient monitors in the near future. Just as the discipline of anesthesiology has, the patient monitoring that accompanies it has come a long way from its beginnings in the mid-19th century. Extrapolating from careful observations of the prevailing trends that have shaped anesthesia patient monitoring historically, patient monitoring in the future will use noncontact technologies, will predict the trajectory of a patient's vital signs, will add regional vital signs to the current systemic ones, and will facilitate directed and supervised anesthesia care over the broader scope that anesthesia will be responsible for.

Ti3C2Tx-rGO-chitosan-based microcatheter sensor for real-time continuous monitoring of propofol: toward improved anesthetic management

We are aiming to develop an electrochemical microcatheter sensor for the detection and real-time continuous monitoring of propofol (PPF), which is an anesthetic drug majorly used during medical treatment. This proposed microcatheter-based sensing strategy meets the challenge of real-time periodic and continuous monitoring of propofol by using d-Ti3C2Tx-rGO-chi-modified carbon paste microcatheter sensor transducer. The sensing methodology relies on voltammetry and chronoamperometry transduction methods. The reusable microcatheter sensor was fabricated by embedding the three electrodes into a few millimeters-wide Teflon tube. The nanocomposite was characterized using advanced analytical instruments such as XRD, FE-SEM, EDX, Raman spectroscopy, and XPS. Further, electrode interfacial properties were characterized with voltammetry and electrochemical impedance spectroscopy. The electroanalytical performance of the modified microcatheter sensor was tested for the detection of PPF in phosphate buffer by using chronoamperometry with a wide linear range of 5 to 110 µM (at an applied potential of 0.3 V vs. Ag/AgCl). The sensor's practical potency was confirmed in human serum with a dynamic linear range of 10 to 130 µM. The sensor exhibited a good limit of detection values in phosphate buffer (2 µM) and natural human plasma (4 µM). The new sensor displays different dimensions of information while displaying high sensitivity, selectivity, and long-term stability. The outstanding analytical performance of the developed sensor holds considerable promise for the continuous monitoring of propofol, its effective management, and optimization of the doses in the patient's body.

Dynamic headspace solid-phase extraction at room temperature: a theoretical model, method, and application for propofol analysis

Herein, a simple dynamic headspace solid-phase extraction (DHS-SPE) process at room temperature was used for a material that is sensitive to increase in the temperature. A proposed method was implemented to rapidly extract propofol (PF) from a complex matrix before fluorescence spectroscopy analysis, within a short sampling time without involving a hot plate or stirrer. A mini diaphragm pump was used to circulate the headspace gas. As the headspace gas flows over the sample solution surface, bubbles form and release analytes from the liquid into the headspace. During the extraction process, the headspace gas passes through the coated metal foam as a sorbent that is placed in a homemade glass vessel and analytes are trapped from the gas phase. A theoretical model of DHS-SPE based on the consecutive first-order process is proposed in this study. A mathematical solution for the dynamic process of mass transfer was obtained by correlating the variation in analyte concentration in the headspace and adsorber with the pump speed and amount of analyte extracted to the solid phase. Using electrochemically Nafion-doped polypyrrole (PPy-Naf) film on nickel foam as the solid-phase coupled to fluorescence detection, a linear dynamic range over the concentration range of 100-500 nM with a detection limit of 15 nM was obtained. This method was applied successfully for PF determination in human serum sample matrices without the interference of co-administered drugs, such as cisatracurium, which have significant emission spectrum overlap. The developed method can lead to a new idea for sample pretreatment, which is compatible with many analytical techniques and has been successfully combined with fluorescence spectroscopy in this work. This format of sampling simplifies the transfer of analytes from complex matrices to the headspace for the extraction and preconcentration process, eliminating the heating step and the need for expensive equipment.

A review on advances in the development of electrochemical sensors for the detection of anesthetic drugs

Surgeries are a crucial medical intervention that has saved countless lives from time immemorial. To reduce pain during surgeries patients are administered with anesthetic drugs, which cause loss of sensation and thus reduce the pain involved. However, anesthetists control the effects of the drug by depending on pharmacokinetic calculations, which may vary from patient to patient, thus leading to a reduction in the quality of anesthetic care and adverse effects. To avoid these adverse effects, it is highly necessary to implement a real time monitoring of plasma drug concentration, which will adjust the drug infusion and maintain the levels of drug within therapeutic levels. To implement such a system, it is highly essential to analyze current advances in electrochemical sensor systems for different types of anesthetic drugs like opioids, intravenous anesthetics, and neuromuscular blockers. This review focuses on the present strategy of electrochemical sensors implemented for the detection of anesthetic drugs and it helps towards developing a real time drug dispensing system with respect to the plasma concentration of the drug. This analysis will contribute towards establishing highly effective real time drug dispensing systems like the total intravenous anesthesia technique and patient-controlled analgesia. Such systems will lead to better usage of anesthetic drugs and improve the quality of anesthetic care thus making surgeries safer and more painless.

Development of a Graphene-Oxide-Deposited Carbon Electrode for the Rapid and Low-Level Detection of Fentanyl and Derivatives

The opioid overdose crisis in North America worsened during the COVID-19 pandemic, with multiple jurisdictions reporting more deaths per day due to the fentanyl-contaminated drug supply than COVID-19. The rapid quantitative detection of fentanyl in the illicit opioid drug supply or in bodily fluids at biologically relevant concentrations (i.e., <80 nM) remains a significant challenge. Electroanalytical techniques are inexpensive and can be used to rapidly detect fentanyl, but detection limits need to be improved. Herein, we detail the development of an electrochemical-based fentanyl analytical detection strategy that used a glassy carbon electrode modified with electrochemically reduced graphene oxide (ERGO) via electrophoretic deposition. The resulting surface was further electrochemically reduced in the presence of fentanyl to enhance the sensitivity. Multiple ERGO thicknesses were prepared in order to prove the versatility and ability to fine-tune the layer to the desired response. Fentanyl was detected at <10 ppb (<30 nM) with a limit of detection of 2 ppb and a calibration curve that covered 4 orders of concentration (from 1 ppb to 10 ppm). This method was sensitive to fentanyl analogues such as carfentanil. Interference from the presence of 100-fold excess of other opioids (heroin, cocaine) or substances typically found in illicit drug samples (e.g. caffeine and sucrose) was not significant.

Recent Developments in the Sensitive Electrochemical Assay of Common Opioid Drugs

Opioids are a class of drugs used to treat moderate to severe pain and have short-term adverse effects. Nevertheless, they are considered necessary for pain management. However, well-known hazards are connected with an opioid prescription, such as overuse, addiction, and overdose deaths. For example, the death rate from opioid analgesic poisoning in the USA approximately doubled, owing to the overuse and addiction of opioid analgesics. Also, opioids are a very important group of analytes in forensic chemistry, so it is necessary to use reliable, fast, and sensitive analytical tools to determine opioid analgesics. This review focuses on the opioid overdose crisis, the properties of commonly used opioid drugs, their mechanism, effects, and some chromatographic and spectroscopic detection methods are explained briefly. Then most essentially recent developments covering the last ten years in the sensitive electrochemical methods of common opioid analgesics, their innovations and features, and future research directions are presented.

Tracking Antioxidant Status in Spinal Cord Injured Rodents: A Voltammetric Method Suited for Clinical Translation

BACKGROUND

Spinal cord injury (SCI) triggers a signalling cascade that produces oxidative stress and damages the spinal cord. Voltammetry is a clinically accessible technique to detect, monitor, and guide correction of this potentially reversible secondary injury mechanism. Voltammetry is well suited for clinical translation because the method is inexpensive, simple, rapid, and portable. Voltammetry relies on the measurement of anodic current from a reagent-free, electrochemical reaction on the surface of a small electrode.

METHODS

The present study tested the use of new disposable carbon nanotube based screen printed electrodes (CNT-SPE) for the voltammetric measurement of antioxidant current (AC). Spinal cord, cerebrospinal fluid, and plasma were obtained from Sprague-Dawley rats after SCI. Locomotor function after SCI was assessed by using the Basso, Beattie, Bresnahan (BBB) score.

RESULTS

The more severe SCI caused a decline in spinal cord AC₄₁₉ at 10 minutes (P < 0.05), 4 hours (P < 0.0001), and 1 day (P < 0.01) after injury compared with sham controls. It also caused a decline in plasma AC₃₇₅ at 1 (P < 0.001) and 3 days (P < 0.05) after injury compared with their pre-injury baseline. Spinal cord AC₄₁₉ correlated with plasma AC₃₇₅ (r = 0.49, P < 0.01) and BBB score (r = 0.66, P < 0.0001) at 1 day after SCI.

CONCLUSIONS

AC measured by CNT-SPE demonstrated a time- and severity-dependent decline after SCI. Plasma AC could serve as a surrogate marker for spinal cord AC.

Electroanalysis of Fentanyl and Its New Analogs: A Review

The review describes fentanyl and its analogs as new synthetic opioids and the possibilities of their identification and determination using electrochemical methods (e.g., voltammetry, potentiometry, electrochemiluminescence) and electrochemical methods combined with various separation methods. The review also covers the analysis of new synthetic opioids, their parent compounds, and corresponding metabolites in body fluids, such as urine, blood, serum, and plasma, necessary for a fast and accurate diagnosis of intoxication. Identifying and quantifying these addictive and illicit substances and their metabolites is necessary for clinical, toxicological, and forensic purposes. As a reaction to the growing number of new synthetic opioid intoxications and increasing fatalities observed over the past ten years, we provide thorough background for developing new biosensors, screen-printed electrodes, or other point-of-care devices.

Electronically integrated microcatheters based on self-assembling polymer films

Existing electronically integrated catheters rely on the manual assembly of separate components to integrate sensing and actuation capabilities. This strongly impedes their miniaturization and further integration. Here, we report an electronically integrated self-assembled microcatheter. Electronic components for sensing and actuation are embedded into the catheter wall through the self-assembly of photolithographically processed polymer thin films. With a diameter of only about 0.1 mm, the catheter integrates actuated digits for manipulation and a magnetic sensor for navigation and is capable of targeted delivery of liquids. Fundamental functionalities are demonstrated and evaluated with artificial model environments and ex vivo tissue. Using the integrated magnetic sensor, we develop a strategy for the magnetic tracking of medical tools that facilitates basic navigation with a high resolution below 0.1 mm. These highly flexible and microsized integrated catheters might expand the boundary of minimally invasive surgery and lead to new biomedical applications.

Flexible and integrated dual carbon sensor for multiplexed detection of nonylphenol and paroxetine in tap water samples

Multiplex detection of emerging pollutants is essential to improve quality control of water treatment plants, which requires portable systems capable of real-time monitoring. In this paper we describe a flexible, dual electrochemical sensing device that detects nonylphenol and paroxetine in tap water samples. The platform contains two voltammetric sensors, with different working electrodes that were either pretreated or functionalized. Each working electrode was judiciously tailored to cover the concentration range of interest for nonylphenol and paroxetine, and square wave voltammetry was used for detection. An electrochemical pretreatment with sulfuric acid on the printed electrode enabled a selective detection of nonylphenol in 1.0-10 × 10^-6 mol L^-1 range with a limit of detection of 8.0 × 10^-7 mol L^-1. Paroxetine was detected in the same range with a limit of detection of 6.7 × 10^-7 mol L^-1 using the printed electrode coated with a layer of carbon spherical shells. Simultaneous detection of the two analytes was achieved in tap water samples within 1 min, with no fouling and no interference effects. The long-term monitoring capability of the dual sensor was demonstrated in phosphate buffer for 45 days. This performance is statistically equivalent to that of high-performance liquid chromatography (HPLC) for water analysis. The dual-sensor platform is generic and may be extended to other water pollutants and clinical biomarkers in real-time monitoring of the environment and health conditions. Silver pseudo-reference electrodes for paroxetine (REP) and nonylphenol (REN), working electrodes for paroxetine (WP) and nonylphenol (WN), and auxiliary electrode (AE). USP refers to the University of Sao Paulo. "Red" is reduced form and "Oxi" is oxidized form of analytes.

Utilization of FAD-Glucose Dehydrogenase from T. emersonii for Amperometric Biosensing and Biofuel Cell Devices

Flavin-dependent glucose dehydrogenases (FAD-GDH) are oxygen-independent enzymes with high potential to be used as biocatalysts in glucose biosensing applications. Here, we present the construction of an amperometric biosensor and a biofuel cell device, which are based on a thermophilic variant of the enzyme originated from Talaromyces emersonii. The enzyme overexpression in Escherichia coli and its isolation and performance in terms of maximal bioelectrocatalytic currents were evaluated. We examined the biosensor's bioelectrocatalytic activity in 2,6-dichlorophenolindophenol-, thionine-, and dichloro-naphthoquinone-mediated electron transfer configurations or in a direct electron transfer one. We showed a negligible interference effect and good stability for at least 20 h for the dichloro-naphthoquinone configuration. The constructed biosensor was also tested in interstitial fluid-like solutions to show high bioelectrocatalytic current responses. The bioanode was coupled with a bilirubin oxidase-based biocathode to generate 270 μW/cm2 in a biofuel cell device.

Electrochemical Detection of Morphine in Untreated Human Capillary Whole Blood

Disposable single-use electrochemical sensor strips were used for quantitative detection of small concentrations of morphine in untreated capillary whole blood. Single-walled carbon nanotube (SWCNT) networks were fabricated on a polymer substrate to produce flexible, reproducible sensor strips with integrated reference and counter electrodes, compatible with industrial-scale processes. A thin Nafion coating was used on top of the sensors to enable direct electrochemical detection in whole blood. These sensors were shown to detect clinically relevant concentrations of morphine both in buffer and in whole blood samples. Small 38 μL finger-prick blood samples were spiked with 2 μL of morphine solution of several concentrations and measured without precipitation of proteins or any other further pretreatment. A linear range of 0.5-10 μM was achieved in both matrices and a detection limit of 0.48 μM in buffer. In addition, to demonstrate the applicability of the sensor in a point-of-care device, single-determination measurements were done with capillary samples from three subjects. An average recovery of 60% was found, suggesting that the sensor only measures the free, unbound fraction of the drug. An interference study with other opioids and possible interferents showed the selectivity of the sensor. This study clearly indicates that these Nafion/SWCNT sensor strips show great promise as a point-of-care rapid test for morphine in blood.

Strategies for Biomolecular Analysis and Continuous Physiological Monitoring

Portable devices capable of rapid disease detection and health monitoring are crucial to decentralizing diagnostics from clinical laboratories to the patient point-of-need. Although technologies have been developed targeting this challenge, many require the use of reporter molecules or reagents that complicate the automation and autonomy of sensors. New work in the field has targeted reagentless approaches to enable breakthroughs that will allow personalized monitoring of a wide range of biomarkers on demand. This Perspective focuses on the ability of reagentless platforms to revolutionize the field of sensing by allowing rapid and real-time analysis in resource-poor settings. First, we will highlight advantages of reagentless sensing techniques, specifically electrochemical detection strategies. Advances in this field, including the development of wearable and in situ sensors capable of real-time monitoring of biomarkers such as nucleic acids, proteins, viral particles, bacteria, therapeutic agents, and metabolites, will be discussed. Reagentless platforms which allow for wash-free, calibration free-detection with increased dynamic range are highlighted as a key technological advance for autonomous sensing applications. Furthermore, we will highlight remaining challenges which must be overcome to enable widespread use of reagentless devices. Finally, future prospects and potential breakthroughs in precision medicine that will arise as a result of further development of reagentless sensing approaches are discussed.

Multimodal/Multifunctional Nanomaterials in (Bio)electrochemistry: Now and in the Coming Decade

Multifunctional nanomaterials, defined as those able to achieve a combined effect or more than one function through their multiple functionalization or combination with other materials, are gaining increasing attention in the last years in many relevant fields, including cargo targeted delivery, tissue engineering, in vitro and/or in vivo diseases imaging and therapy, as well as in the development of electrochemical (bio)sensors and (bio)sensing strategies with improved performance. This review article aims to provide an updated overview of the important advances and future opportunities exhibited by electrochemical biosensing in connection to multifunctional nanomaterials. Accordingly, representative aspects of recent approaches involving metal, carbon, and silica-based multifunctional nanomaterials are selected and critically discussed, as they are the most widely used multifunctional nanomaterials imparting unique capabilities in (bio)electroanalysis. A brief overview of the main remaining challenges and future perspectives in the field is also provided.

Wearable Electrochemical Sensors for the Monitoring and Screening of Drugs

Wearable electrochemical sensors capable of noninvasive monitoring of chemical markers represent a rapidly emerging digital-health technology. Recent advances toward wearable continuous glucose monitoring (CGM) systems have ignited tremendous interest in expanding such sensor technology to other important fields. This article reviews for the first time wearable electrochemical sensors for monitoring therapeutic drugs and drugs of abuse. This rapidly emerging class of drug-sensing wearable devices addresses the growing demand for personalized medicine, toward improved therapeutic outcomes while minimizing the side effects of drugs and the related medical expenses. Continuous, noninvasive monitoring of therapeutic drugs within bodily fluids empowers clinicians and patients to correlate the pharmacokinetic properties with optimal outcomes by realizing patient-specific dose regulation and tracking dynamic changes in pharmacokinetics behavior while assuring the medication adherence of patients. Furthermore, wearable electrochemical drug monitoring devices can also serve as powerful screening tools in the hands of law enforcement agents to combat drug trafficking and support on-site forensic investigations. The review covers various wearable form factors developed for noninvasive monitoring of therapeutic drugs in different body fluids and toward on-site screening of drugs of abuse. The future prospects of such wearable drug monitoring devices are presented with the ultimate goals of introducing accurate real-time drug monitoring protocols and autonomous closed-loop platforms toward precise dose regulation and optimal therapeutic outcomes. Finally, current unmet challenges and existing gaps are discussed for motivating future technological innovations regarding personalized therapy. The current pace of developments and the tremendous market opportunities for such wearable drug monitoring platforms are expected to drive intense future research and commercialization efforts.