Adenosine triphosphate infusion in patients with cancer pain: a pilot study

Abstract

Introduction. About 50–66 % patients with cancer suffered from intensive pain when are given analgesics. Objectives. We investigated the effectiveness of intravenous infusion of non-selective purine receptors agonist adenosine triphosphate in cancer patients with moderate and severe pain who had being received non-selective inhibitor of cyclooxygenase plus weak opioid tramadol. Materials and methods. Sixty-seven patients in which pain sensations were localized in different regions were scheduled for the study. The intravenous infusion of adenosine triphosphate 35–45 mcg kg(–1) min(–1) was performed within the period from 100 to 160 minutes. Pain severity was estimated by numeric verbal scale where “0” — no pain and “10” — maximal pain. Moreover, we studied prognostic significance of the original scale that was based on patient’s ability to pointed out precisely the pain sensation margins where “1” — patient can specify exactly the margins of pain sensations on the skin; “2” — patient can indicate approximately zone with pain sensation (periarticular tissue or bone or big muscle); and “3” — patient can determine large anatomical region only. Analysis of correlations was performed between scale value and the effectiveness of adenosine triphosphate infusion. Results. We revealed that 79 % (53 out of 67) patients have pointed out to pain relief after infusion with more than 20 % reduction of pain intensity (p = 0.0000001 — Wilcoxon signed rank test). As results, we obtained statistically correlation link (p = 0.02 — gamma-test and p = 0.02 — Kendall tau rank correlation coefficient) between the adenosine triphosphate infusion effectiveness and pain type with high precision of the pain sensation margins. Conclusions. Intravenous infusion of adenosine triphosphate has the high effectiveness for pain relief in cancer patients particularly when pain sensation margins high precisely detected to be.