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Intrathecal adenosine administration in abdominal hysterectomy lacks analgesic effect

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Abstract:

Background:

Adenosine (Ado) is known, from studies in both animals and humans, to produce antinociception when administered systemically or intrathecally (IT). The current aim was to evaluate, in a placebo-controlled, randomised, double-blind study, whether IT adenosine given before surgery could reduce anaesthetic requirement and the need of opioids during 48 h after visceral surgery.

Method:

Forty women (37–66 years, ASA I and II) scheduled for elective hysterectomy were included. Before inducing the standardised O2/N2O/isoflurane/fentanyl anaesthesia, the patients received an IT injection of either adenosine (500 μg in 1 ml volume) or placebo 1 ml (saline). Intraoperative anaesthetic drug doses and haemodynamics were recorded. Postoperative pain was assessed by visual analogue scale. For postoperative analgesia, cetobemidone was provided via intravenous patient-controlled analgesia (PCA).

Results:

During surgery, there were no differences between groups in anaesthetic requirement or haemodynamic parameters. Postoperative cetobemidone requirements were similar in both groups (median 48 mg for adenosine/50 mg for saline) during the first 48 postoperative hours.

Conclusion:

IT adenosine did not influence the requirement of anaesthetic drug or postoperative analgesics after hysterectomy.

Keywords: Anesthetic requirement; patient-controlled analgesia (PCA); postoperative visceral pain

Document Type: Original Article

Affiliations: 1: Departments of Anaesthesia and Intensive Care, Danderyd Hospital, Danderyd and 2: Huddinge University Hospital, Huddinge, Sweden

Publication date: August 1, 2000

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