{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T01:18:49Z","timestamp":1793755129033,"version":"4.6.1"},"reference-count":44,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004756","name":"Emil Aaltosen S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004756","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The use of intranasal dexmedetomidine is hampered by a limited understanding of its absorption pharmacokinetics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We examined the pharmacokinetics and feasibility of intranasal dexmedetomidine administered in the supine position to adult patients undergoing general anaesthesia. Twenty\u2010eight patients between 35 and 80\u2009years of age, ASA 1\u20133 and weight between 50 and 100\u2009kg, who underwent elective unilateral total hip or knee arthroplasty under general anaesthesia were recruited. All patients received 100\u2009\u03bcg of intranasal dexmedetomidine after anaesthesia induction. Six venous blood samples (at 0, 5, 15, 45, 60, 240\u2009min timepoints from dexmedetomidine administration) were collected from each patient and dexmedetomidine plasma concentrations were measured. Concentration\u2010time profiles after nasal administration were pooled with earlier data from a population analysis of intravenous dexmedetomidine (<jats:italic>n<\/jats:italic>\u2009=\u2009202) in order to estimate absorption parameters using nonlinear mixed effects. Peak concentration (<jats:italic>C<\/jats:italic><jats:sub>MAX<\/jats:sub>) and time (<jats:italic>T<\/jats:italic><jats:sub>MAX<\/jats:sub>) were estimated using simulation (<jats:italic>n<\/jats:italic>\u2009=\u20091000) with parameter estimates and their associated variability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 28 adult patients with a mean (SD) age of 66 (8) years and weight of 83 (10) kg. The mean weight\u2010adjusted dose of dexmedetomidine was 1.22 (0.15) \u03bcg kg<jats:sup>\u22121<\/jats:sup>. <jats:italic>C<\/jats:italic><jats:sub>MAX<\/jats:sub> 0.273\u2009\u03bcg\u2009L<jats:sup>\u22121<\/jats:sup> was achieved at 98\u2009min after intranasal administration (<jats:italic>T<\/jats:italic><jats:sub>MAX<\/jats:sub>). The relative bioavailability of dexmedetomidine was 80% (95% CI 75\u201391%). The absorption half\u2010time (<jats:italic>T<\/jats:italic><jats:sub>ABS<\/jats:sub>\u2009=\u2009120\u2009min; 95% CI 90\u2013147\u2009min) was slower than that in previous pharmacokinetic studies on adult patients. Perioperative haemodynamics of all patients remained stable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Administration of intranasal dexmedetomidine in the supine position during general anaesthesia is feasible with good bioavailability. This administration method has slower absorption when compared to awake patients in upright position, with consequent concentrations attained after <jats:italic>T<\/jats:italic><jats:sub>MAX<\/jats:sub> for several hours.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14473","type":"journal-article","created":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T12:04:08Z","timestamp":1718798648000},"page":"1182-1191","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Absorption pharmacokinetics and feasibility of intranasal dexmedetomidine in patients under general anaesthesia"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2047-3767","authenticated-orcid":false,"given":"Suvi\u2010Maria","family":"Tiainen","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care University of Turku  Turku Finland"},{"name":"Division of Perioperative Services Intensive Care and Pain Medicine, Turku University Hospital  Turku Finland"},{"name":"Department of Anaesthesiology and Intensive Care Satasairaala Central Hospital, Satakunta Hospital District  Pori Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2826-3019","authenticated-orcid":false,"given":"Brian J.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ella","family":"Rinne","sequence":"additional","affiliation":[{"name":"Medical faculty, University of Turku  Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5713-5692","authenticated-orcid":false,"given":"Aleksi","family":"Tornio","sequence":"additional","affiliation":[{"name":"Unit of Clinical Pharmacology, Turku University Hospital  Turku Finland"},{"name":"Bioanalytical Laboratory, Institute of Biomedicine, University of Turku  Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4123-6039","authenticated-orcid":false,"given":"Marica T.","family":"Engstr\u00f6m","sequence":"additional","affiliation":[{"name":"Bioanalytical Laboratory, Institute of Biomedicine, University of Turku  Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1225-4561","authenticated-orcid":false,"given":"Teijo I.","family":"Saari","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care University of Turku  Turku Finland"},{"name":"Division of Perioperative Services Intensive Care and Pain Medicine, Turku University Hospital  Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5120-8854","authenticated-orcid":false,"given":"Panu","family":"Uusalo","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care University of Turku  Turku Finland"},{"name":"Division of Perioperative Services Intensive Care and Pain Medicine, Turku University Hospital  Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/ANA.0000000000000403"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30580-3"},{"key":"e_1_2_11_4_1","first-page":"1","article-title":"Dexmedetomidine prevent postoperative nausea and vomiting on patients during general anesthesia: a PRISMA\u2010compliant meta analysis of randomized controlled trials","volume":"96","author":"Jin S","year":"2017","journal-title":"Medicine (United States)"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep12342"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/6136105"},{"key":"e_1_2_11_7_1","unstructured":"Therapeutics B. 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