Prognosis of adenosine triphosphate infusion for anticonvulsants efficacy in patients with intensive cancer pain: a prospective observational study
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adenosine triphosphate
cancer pain

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Karelov AE, Ryazankina AA, Semkichev VA Prognosis of adenosine triphosphate infusion for anticonvulsants efficacy in patients with intensive cancer pain: a prospective observational study. Annals of Critical Care. 2022;(4):135–143. doi:10.21320/1818-474X-2022-4-135-143.


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INTRODUCTION: Pain is a common symptom in cancer patients even when analgesics were given. OBJECTIVE: To assess the prognostic value of intravenous infusion of non-selective purine receptors agonist adenosine triphosphate for effectiveness of anticonvulsant gabapentin in cancer patients with moderate and severe pain who received non-selective inhibitor of cyclooxygenase plus weak opioid tramadol. MATERIALS AND METHODS: Thirty-four cancer patients with intensive pain were scheduled for the study. The intravenous infusion of adenosine triphosphate 35–45 mg∙kg–1∙min–1 was performed within the period from 100 to 160 minutes. Then all patients were taken gabapentin (900 mg in three times daily). Pain was estimated 30 minutes before infusion, 30 minutes after infusion, and after taking 900 mg/day gabapentin for 4 days. Moreover, we studied prognostic significance of adenosine triphosphate infusion for the effectiveness of gabapentin administration. RESULTS: We revealed significant reduction of pain intensity after adenosine triphosphate infusion (Z = 4.0; р < 0.0001 — Wilcoxon signed rank test). The same result was obtained after taking of gabapentin for 4 days (Z = 4.9; р < 0.0001 — Wilcoxon signed rank test). Moreover, we found statistically moderate correlation link (t(N – 2) = 3.94; closeness correlation = 0.57; р < 0.0004 — Spearman’s rank correlation coefficient) between pain intensity value after adenosine triphosphate infusion and taking of gabapentin. Regression analysis demonstrated satisfactory predictive ability of the resulting model (R2 = 0.55 (corrected R2 = 0.53); F = 38.74; р < 0.0001). CONCLUSIONS: 1. Intravenous infusion of adenosine triphosphate may has significance for prognosis of taking anticonvulsant gabapentin effectiveness in cancer patients with moderate and severe pain who received non-selective cyclooxygenase inhibitor plus weak opioid tramadol. 2. Intravenous infusion of adenosine triphosphate or taking anticonvulsant gabapentin may significantly reduce pain intensity in cancer patients who had weak effect of administration of non-selective inhibitor of cyclooxygenase plus weak opioid tramadol.
PDF_2022-4_135-143 (Русский)
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  1. International Association for the Study of Pain. IASP. Cancer Pain. URL: (accessed May 20, 2022)
  2. Laws & Regulations Database of The Republic of China (2014). Regulations for Cancer Care Quality Assurance Measures. Laws & Regulations Database of The Republic of China. URL: = L0070016 (accessed May 20, 2022)
  3. Lin C.C., Lai Y.L., Ward S.E. Effect of cancer pain on performance status, mood states, and level of hope among Taiwanese cancer patients. J Pain Symptom Manag. 2003; 25(1): 29–37. DOI: 10.1016/s0885-3924(02)00542-0
  4. Deandrea S., Montanari M., Moja L., Apolone G. Prevalence of undertreatment in cancer pain. A review of published literature. Ann Oncol. 2008; 19(12): 1985–91. DOI: 10.1093/annonc/mdn419
  5. García de Paredes M.L., del Moral González F., Martínez del Prado P., et al. First evidence of oncologic neuropathic pain prevalence after screening 8615 cancer patients. Results of the On-study. Ann Oncol. 2011; 22(4): 924–30. DOI: 1093/annonc/mdq449
  6. Rayment C., Hjermstad M.J., Aass N., et al. Neuropathic cancer pain: prevalence, severity, analgesics and impact from the European Palliative Care Research Collaborative-Computerised Symptom Assessment study. Palliat Med. 2013; 27(8): 714–21. DOI: 10.1177/0269216312464408
  7. Finnerup N.B., Sindrup S.H., Jensen T.S. The evidence for pharmacological treatment of neuropathic pain. Pain. 2010; 150(3): 573–81. DOI: 10.1016/j.pain.2010.06.019
  8. Chen D.L., Li Y.H., Wang Z.J., Zhu Y.K. The research on long-term clinical effects and patients’ satisfaction of gabapentin combined with oxycontin in treatment of severe cancer pain. Medicine (Baltimore). 2016; 95(42): e5144. DOI: 10.1097/MD.0000000000005144
  9. Sollevi A. Adenosine infusion during isoflurane-nitrous oxide anaesthesia: indications of perioperative analgesic effect. Acta Anesthesiol Scand. 1992; 36(6): 595–9.
  10. Reeve A.J., Dickenson A.H. 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: 2221–8.
  11. Belfrage M., Sollevi A., Segerdahl M., et al. Systemic adenosine infusion alleviates spontaneous and stimulus evoked pain in patients with peripheral neuropathic pain. Anesth Analg. 1995; 81(4): 713–7. DOI: 10.1097/00000539-199510000-00010
  12. Lynch M.E., Clark A.J., Sawynok J. Intravenous adenosine alleviates neuropathic pain: a double blind placebo controlled crossover trial using an enriched enrolment design. Pain. 2003; 103(1–2): 111–7. DOI: 10.1016/s0304-3959(02)00419-0
  13. Карелов А.Е. Сравнение потребности в миорелаксантах во время абдоминальных операций на фоне пуриновой или опиоидной анальгезии. Эфферентная терапия. 2010; 16(4): 47–50. [Karelov A.E. Comparison of the need for muscle relaxants during abdominal surgery on the background of purine or opioid analgesia. Efferentnaya terapiya. 2010; 16(4): 47–50. (In Russ)]
  14. Карелов А.Е., Рязанкина А.А., Хохлова Е.А., Васильева Г.Н., Семкичев В.А. Применение инфузии трифосаденина у онкологических пациентов с болью: пилотное исследование. Вестник интенсивной терапии им. А.И. Салтанова. 2021; 4: 115–121.DOI: 21320/1818-474X-2021-4-115-121 [Karelov A.E., Ryazankina A.A., Khokhlova E.A., Vasilieva G.N., Semkichev V.A. Adenosine triphosphate infusion in patients with cancer pain: a pilot study. Annals of Critical Care. 2021; 4: 115–121. DOI: 10.21320/1818-474X-2021-4-115-121 (In Russ)]
  15. Boison D. Adenosine and epilepsy: from therapeutic rationale to new therapeutic strategies. Neuroscientist. 2005; 11: 25–36. DOI: 10.1177/1073858404269112
  16. Bouhassira D., Attal N., Alchaar H., et al. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain. 2005; 114(1–2): 29–36. DOI:1016/j.pain.2004.12.010
  17. Осипова Н.А. Современные тенденции в науке и практике лечения боли. Анестезиология и реаниматология. 2014; 2: 26–32. [Osipova N.A. Modern global tendencies in the research and practice of pain treatment trends in world science and practice of pain treatment. Anaesthesiology and reanimatology. 2014; 2: 26–32. (In Russ)]
  18. Карелов А.Е. Современные представления о механизмах боли. Анестезиология и реаниматология. 2020; 6: 88–95. DOI: 10.17116/anaesthesiology202006187 [Karelov A.E. Modern concepts of pain mechanisms. Russian Journal of Anaesthesiology and Reanimatology or Anesthesiologiya and reanimatologiya. 2020; 6: 88–95. DOI: 10.17116/anaesthesiology202006187 (In Russ)]
  19. Yang J., Bauer B.A., Wahner-Roedler D.L., et al. The Modified WHO Analgesic Ladder: Is It Appropriate for Chronic Non-Cancer Pain? J Pain Res. 2020; 13: 411–7. DOI: 10.2147/JPR.S244173
  20. Caraceni A., Zecca E., Bonezzi C. Gabapentin for neuropathic cancer pain: a randomized controlled trial from the Gabapentin Cancer Pain Study Group. J Clin Oncol. 2004; 22(14): 2909–17. DOI: 10.1200/JCO.2004.08.141
  21. Хусаинова И.И., Баялиева А.Ж., Браун М.К. Современные подходы к лечению послеоперационной боли в онкогинекологии. Вестник интенсивной терапии. 2017; 4: 13–8. [Khusainova I.I., Bayalieva A.Z., Braun M.K. Modern approach to postoperative pain treatment in oncogynecology. Intensive care herald. 2017; 4: 13–8. (In Russ)]
  22. Карелов А.Е. Принципы анальготестирования в клинической альгологии Вестник интенсивной терапии. 2014; 3: 34–7. [Karelov A.E. The analgotesting principles in clinical algology. Intensive care herald. 2014; 3: 34–7. (In Russ)]
  23. Карелов А.Е., Семенов Д.А., Патлай И.В., Федорова Т.Н. Пуриновая анальгезия во время хирургических вмешательств: побочные эффекты и осложнения. Медлайн.ру [Электронный ресурс]. 2011; 12(4): 353–63. [Karelov A.E., Semenov D.A., Patlay I.V., Fedorova T.N. Purine analgesia during surgery: noxious effects and complications. ru [Elektronnyj resurs]. 2011; 12(4): 353–63. (In Russ)]
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