A Nanochiral Biosensor Enables Clinical Anesthesia Monitoring

10%, that is, over 32 million patients-suffer from inadequate anesthesia monitoring in surgical procedures yearly, global-results in unwanted intraoperative risks. On-site, precise analysis of anesthesia concentration during patient surgery is highly desired yet has not been achieved owing to the lack of a satisfactory biosensor device: it allows sample collection-and-detection seamlessly and in a timely manner. Here, we introduce a new chiral plasma biosensor, a tandem integrating of one 3D nano-helical silver array with an optofluidic chip that enables real-time depth of anesthesia monitoring during surgery. The patient's blood flows into and is processed through our device's designed channel, where capillary-driven flow enables rapid plasma separation from whole blood. The isolated plasma is then directly delivered to the surface-enhanced Raman scattering (SERS) sensing region, and diverse functional anesthetics in blood are meanwhile recognized by the chiral plasma detector. The cost-effective sensor enables the detection limitation at a level of 0.1 µg/mL, and more importantly, all analyses are completed within a minute level, showing an advance compared to current hour/day suboptimal temporal resolution. We further apply this device in the clinic, monitor the anesthetics, and offer individual drug metabolism profiles in various patients. In addition, this precise, on-site, and real-time biochip features a user-friendly diagnostic system that uses mobile applications and portable accessories to address critical clinical needs, providing an opportunity for personalized anesthesia management based on patient-specific needs.