Intrathecal adenosine administration in abdominal hysterectomy lacks analgesic effect

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 Il) scheduled for elective hysterectomy were included. Before inducing the standardised O-2/N2O/isoflurane/fentanyl anaesthesia, the patients received an IT injection of either adenosine (500 mu g in 1 mi volume) or placebo I mi (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 bath 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.