• Journal of anesthesia · Jan 2005

    Comparative Study Clinical Trial

    Analgesic effect of intravenous ATP on postherpetic neuralgia in comparison with responses to intravenous ketamine and lidocaine.

    • Masakazu Hayashida, Ken-Ichi Fukuda, Atsuo Fukunaga, Aki Meno, Kanako Sato, Kaoru Tarui, Hideko Arita, Yuzuru Kaneko, and Kazuo Hanaoka.
    • Surgical Center Research Hospital, Institute of Medical Institute, The University of Tokyo, 4-6-1 Shiroganedai, Minato-ku, Tokyo, 108-8639, Japan.
    • J Anesth. 2005 Jan 1;19(1):31-5.

    PurposeNo study has been performed on the analgesic effect of adenosine 5'-triphosphate (ATP) on postherpetic neuralgia (PHN). We conducted an open-label trial of ATP in patients with PHN, and compared ATP with ketamine and lidocaine.MethodsTwelve patients with PHN were studied. On separate days, ketamine (0.3 mg.kg(-1)), lidocaine (2 mg.kg(-1)), and ATP (100 microg.kg(-1).min(-1) or less for 120 min) were administrated intravenously. The intensity of spontaneous pain as well as tactile allodynia was assessed using a visual analog scale (VAS). When the VAS score for spontaneous pain was decreased by more than 50%, the patient was classified as a responder.ResultsFive, 6, and 6 patients responded to ketamine, lidocaine, and ATP, respectively. In 6 ATP responders, pain relief developed slowly and lasted for 9 (median) h (range: 3-72 h). All 5 ketamine responders and only 1 of 7 ketamine nonresponders responded to ATP (5/5 vs 1/7, P < 0.05, chi2 test) whereas 2 of 6 responders to lidocaine and 4 of 6 nonresponders to lidocaine responded to ATP (2/6 vs 4/6, P > 0.05). The ketamine responders responded to ATP more often than did the lidocaine responders (5/5 vs 2/6, P < 0.05).ConclusionIntravenous ATP exerted slowly developing and long-lasting analgesic effects in half of patients with PHN. Patients with ketamine-responsive PHN were likely to respond to ATP.

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