Systemic adenosine infusion reduces the area of tactile allodynia in neuropathic pain following peripheral nerve injury: a multi-centre, placebo-controlled study

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Abstract
Systemic adenosine has been shown in earlier case reports and a small placebo‐controlled study to reducepathological sensory dysfunction such as tactile allodynia in neuropathic pain. To evaluate this further, the effects of systemic adenosine infusion (50 μg/kg/min for 60 min) on tactile sensory dysfunction and pain was evaluated in 26 patients suffering peripheral neuropathic pain characterized by dynamic tactile allodynia. A randomized, cross‐over, double‐blind, placebo‐controlled technique was used in this multi‐centre study. Psychophysical methods were used to evaluate sensory dysfunction and spontaneous pain. The area of dynamic tactile allodynia was significantly reduced by adenosine compared with placebo (p=0.043), but spon‐taneous pain and tactile pain threshold were not significantly improved compared with the effects of placebo treatment. As a secondary outcome, a higher incidence of positive subjective effects on the clinical pain condi‐tion, in a few cases with long duration (several months), following adenosine treatment was found when theglobal effect of respective treatment was assessed (p=0.028). The results demonstrate involvement of adenosine receptor‐sensitive pain mechanisms in some aspects of the sensory dysfunction often found in neuropathic pain.