Segerdahl M, Ekblom A, Sollevi A
Department of Anaesthesia and Intensive Care, Karolinska Hospital, Stockholm, Sweden.
Anesth Analg. 1994 Oct;79(4):787-91. doi: 10.1213/00000539-199410000-00029.
Adenosine, intrathecally administered, produces antinociception in experimental studies on animals. The effect of intravenous (i.v.) adenosine on experimentally induced pain in humans has not been studied. The present single-blind, randomized, placebo-controlled study was conducted in nine healthy volunteers. The pain-reducing effects of adenosine (70 micrograms.kg-1.min-1 i.v.), morphine (0.1 mg/kg i.v.), ketamine (0.1 mg/kg i.v.), adenosine + morphine, and adenosine + ketamine were compared to each other and to placebo in random order. Ischemic pain was induced by the submaximum effort tourniquet technique. Pain was assessed using the visual analog scale (VAS, 0-100 mm). The sums of pain scores (SPS) were compared and found significantly 30%-40% lower for adenosine as well as for the other compounds and combinations (P < 0.03), compared to placebo. The number of subjects who reached VAS 100 within 30 min was significantly lower (P < 0.03) when receiving adenosine + morphine (0/9) and adenosine + ketamine (2/9) than when receiving placebo (7/9). This may indicate an additive effect on pain reduction when adenosine is given in combination with morphine or ketamine. In conclusion, the results indicate that i.v. adenosine, as well as morphine and ketamine, can reduce experimentally induced ischemic muscle pain in healthy volunteers.
鞘内注射腺苷在动物实验研究中可产生抗伤害感受作用。静脉注射腺苷对人体实验性诱导疼痛的影响尚未得到研究。本单盲、随机、安慰剂对照研究在9名健康志愿者中进行。将腺苷（静脉注射70微克·千克⁻¹·分钟⁻¹）、吗啡（静脉注射0.1毫克/千克）、氯胺酮（静脉注射0.1毫克/千克）、腺苷 + 吗啡以及腺苷 + 氯胺酮的镇痛效果相互比较，并与安慰剂按随机顺序进行比较。采用次最大努力止血带技术诱导缺血性疼痛。使用视觉模拟量表（VAS，0 - 100毫米）评估疼痛。比较疼痛评分总和（SPS），发现与安慰剂相比，腺苷以及其他化合物和组合的疼痛评分总和显著降低30% - 40%（P < 0.03）。与接受安慰剂（7/9）相比，接受腺苷 + 吗啡（0/9）和腺苷 + 氯胺酮（2/9）的受试者在30分钟内达到VAS 100的人数显著减少（P < 0.03）。这可能表明腺苷与吗啡或氯胺酮联合使用时对减轻疼痛有相加作用。总之，结果表明静脉注射腺苷以及吗啡和氯胺酮均可减轻健康志愿者实验性诱导的缺血性肌肉疼痛。
