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April 15-16, 2019 | Frankfurt, Germany
Oncology Nursing and Cancer Care
16th International Conference on
Journal of Medical Oncology and Therapeutics | Volume 4
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Does a single dose of adenosine in epidural space reduce cancer-related neuropathic
pain? A randomized clinical trial
Ehsan Shahverdi
University Medicine Greifswald, Germany
Background: Systemic and intrathecal adenosine
reduce chronic neuropathic and nociceptive
pain; however, the effect of adenosine epidural
injection in the treatment of neuropathic cancer-
related pains remains unclear.
Objectives: The objective of this study was to
evaluatetheefficacyofasingleepiduraladministration
of adenosine in alleviating chronic neuropathic pain
in patients with primitive neuroectodermal tumors.
Methods: In this single-blind randomized clinical
trial with the unique ID of IRCT2017031428878N1,
88 patients with chronic neuropathic pain were
divided into twoequivalent groups. Twogroupswere
treated with a single dose epidural administration of
ropivacaine, 0.75 mL/kg from 0.2% solution (both
groups), plus adenosine, 50 mcgr/kg (adenosine
group), or normal saline (control group). Patients
were evaluated on the days 1, 2, 3, 5, 7, 10, and 14
after injection.
Results: Both groups showed a reduction in pain
severity according to verbal rating scale (VRS) (3
± 0.09-1 ± 0.05 in adenosine, 4 ± 0.08-1 ± 0.00 in
the control group) and visual analogue scale (VAS)
(7 ± 0.25-1 ± 0.12 in adenosine, 8 ± 0.22-1 ± 0.06
in the controlgroup); however, this reductionwas
significantlyhigher in the controlgroup(P< 0.0005).
The intensityof neuropathicpain decreased in both
groups according to Douleur Neuropathique 4
questions (DN4) scores(from 5 ± 0.23-1 ± 0.04 in
adenosine group, and from 5.5 ± 0.24-1 ± 0.00 in
the control group) without a significant difference
between the groups (P=0.19). Adenosine group had
less nausea and vomiting (P<0.0005).There was no
significant difference in patient satisfaction levels
between adenosine and control groups (P=0.09).
Conclusions: Administration of bolus epidural
adenosineisnoteffectiveinreducingneuropathicpain
in patients with primitive neuroectodermal tumors.
Speaker Biography
Ehsan Shahverdi is a MD medical graduate (2016), who commenced
his interest in Blood transfusion, cancer treatment and research in
2014. He completed a MD postgraduate qualifications before taking
up positions in transfusion in Iranian Blood Transfusion Organization
(IBTO) and then in cancer treatment and research in MAHAK Pediatric
Cancer Treatment and Research Center. He has been a Council
member of the Blood and Cancer Research Center of the MAHAK
Pediatric Cancer Treatment and Research Center. He is Chairman of the
department of Young Doctors and Researchers of the IPHOS. He has
written over 70 scientific papers and is in demand as a speaker to a
number of international congress. He has a particular interest in the
transfusion services of developing countries and has travelled to many
of them to lecture and assist in practical workshops. Over the years, he
has been awarded life memberships of various organizations and has
won several prestigious awards from medical societies. He is now very
active in various community support organizations.
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