Hostname: page-component-7bb8b95d7b-nptnm Total loading time: 0 Render date: 2024-09-20T08:31:59.405Z Has data issue: false hasContentIssue false
  • English
  • Français

Efficacy of intrathecal adenosine for postoperative pain relief

Published online by Cambridge University Press:  01 March 2006

M. Sharma ,
M. Mohta  and
R. Chawla
M. Sharma
Affiliation:
University College of Medical Sciences and Guru Teg Bahadur Hospital, Department of Anaesthesiology and Critical Care, Delhi, India
M. Mohta
Affiliation:
University College of Medical Sciences and Guru Teg Bahadur Hospital, Department of Anaesthesiology and Critical Care, Delhi, India
R. Chawla
Affiliation:
University College of Medical Sciences and Guru Teg Bahadur Hospital, Department of Anaesthesiology and Critical Care, Delhi, India
Get access

Extract

Summary

Background and objective: Adenosine, by intravenous and intrathecal routes, is known to alleviate various types of pain. However, the role of intrathecal adenosine in providing postoperative analgesia has not been confirmed. The aim of the present study was to evaluate the efficacy of intrathecal adenosine for postoperative pain relief, and to determine its role for pre-emptive analgesia. Methods: Ninety ASA I and II females, undergoing elective abdominal hysterectomy, were randomly divided into three groups of 30 patients each. Patients in the ‘early adenosine’ group received intrathecal adenosine 1000 μg, 30 min before induction of anaesthesia. Patients in the ‘late adenosine’ group received the same dose before reversal of neuromuscular blockade. Control patients did not receive any test drug. A balanced general anaesthesia technique was used in all patients. Pain intensity scores using a visual analogue scale, sedation scores, time to first rescue analgesic and total morphine requirement were recorded. Results: There was no significant difference in pain intensity scores, sedation scores, total morphine requirements and time to first rescue analgesic among the three groups. Conclusion: Intrathecal adenosine 1000 μg is not effective as an analgesic for postoperative pain relief, and there is no pre-emptive effect.

Keywords

DRUG ADMINISTRATION, intrathecalDRUGS, adenosinePAIN, postoperativeANALGESIA, pre-emptive
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 6 , June 2006 , pp. 449 - 453
Copyright
© 2006 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Reeve AJ, Dickenson AH. The roles of spinal adenosine receptors in the control of acute and more persistent nociceptive responses of dorsal horn neurons in the anaesthetized rat. Br J Pharmacol 1995; 116: 2221–2228.Google Scholar
Belfrage M, Sollevi A, Segerdahl M, Sjolund KF, Hansson P. Systemic adenosine infusion alleviates spontaneous and stimulus evoked pain in patients with peripheral neuropathic pain. Anesth Analg 1995; 81: 713–717.Google Scholar
Belfrage M, Segerdahl M, Arner S, Sollevi A. The safety and efficacy of intrathecal adenosine in patients with chronic neuropathic pain. Anesth Analg 1999; 89: 136–142.Google Scholar
Rane K, Segerdahl M, Goiny M, Sollevi A. Intrathecal adenosine administration: a phase I clinical safety study in healthy volunteers, with additional evaluation of its influence on sensory thresholds and experimental pain. Anesthesiology 1998; 89: 1108–1115.Google Scholar
Lynch ME, Clark AJ, Sawynok J. Intravenous adenosine alleviates neuropathic pain: a double blind placebo controlled crossover trial using an enriched enrolment design. Pain 2003; 103: 111–117.Google Scholar
Segerdahl M, Ekblom A, Sandelin K, Wickman M, Sollevi A. Peroperative adenosine infusion reduces the requirements for isoflurane and postoperative analgesics. Anesth Analg 1995; 80: 1145–1149.Google Scholar
Fukunaga AF, Alexander GE, Stark CW. Characterization of the analgesic actions of adenosine: comparison of adenosine and remifentanil infusions in patients undergoing major surgical procedures. Pain 2003; 101: 129–138.Google Scholar
Eisenach JC, Hood DD, Curry R, Sawynok J, Yaksh TL, Li X. Intrathecal but not intravenous opioids release adenosine from the spinal cord. J Pain 2004; 5: 64–68.Google Scholar
Eisenach JC, Rauck RL, Curry R. Intrathecal, but not intravenous adenosine reduces allodynia in patients with neuropathic pain. Pain 2003; 105: 65–70.Google Scholar
Rane K, Sollevi A, Segerdahl M. Intrathecal adenosine administration in abdominal hysterectomy lacks analgesic effect. Acta Anaesthesiol Scand 2000; 44: 868–872.Google Scholar
Rane K, Sollevi A, Segerdahl M. A randomised double-blind evaluation of adenosine as adjunct to sufentanil in spinal labour analgesia. Acta Anaesthesiol Scand 2003; 47: 601–603.Google Scholar
Katz J, Kavanagh BP, Sandler AN et al. Preemptive analgesia. Clinical evidence of neuroplasticity contributing to postoperative pain. Anesthesiology 1992; 77: 439–446.Google Scholar
Ong CKS, Lirk P, Seymour RA, Jenkins BJ. The efficacy of preemptive analgesia for acute postoperative pain management: a meta-analysis. Anesth Analg 2005; 100: 757–773.Google Scholar
Millar AY, Mansfield MD, Kinsella J. Influence of timing of morphine administration on postoperative pain and analgesic consumption. Br J Anaesth 1998; 81: 373–376.Google Scholar
Kissin I. Preemptive analgesia. Anesthesiology 2000; 93: 1138–1143.Google Scholar
Kissin I. Preemptive analgesia at the crossroad. Anesth Analg 2005; 100: 754–756.Google Scholar
Filos KS, Vagianos CE. Pre-emptive analgesia: How important is it in clinical reality? Eur Surg Res 1999; 31: 122–132.Google Scholar