Intraosseous adenosine. As effective as peripheral or central venous administration?
OBJECTIVE
The purpose of this study was to determine if intraosseous administration of adenosine is effective and, if so, to establish therapeutic dosage criteria for the intraosseous route compared with peripheral or central intraosseous route compared with peripheral or central venous routes.


METHODS
Randomized, unblinded, cross-over, within-animal control study.


METHODS
University hospital in Ohio.


METHODS
Thirty newly weaned piglets.


METHODS
Consecutive sample.


METHODS
Thirty newly weaned pigs were transesophageally (n = 26) or transvenously (n = 4) paced at a cycle length that was 10% longer than the Wenckebach threshold. The minimum effective dose of adenosine necessary to induce atrioventricular block during pacing was recorded for peripheral venous, central venous, and intraosseous routes.


RESULTS
The baseline resting heart rate and Wenckebach thresholds were not statistically different between subjects or between different routes of administration. The intraosseous route required a minimum effective dose of 127 micrograms/kg. Using a log transformation, the difference between central venous and peripheral venous doses was found to be statistically significant. The intraosseous dose was not statistically different from the central venous or peripheral venous doses.


CONCLUSIONS
The intraosseous route is an effective way of administering adenosine. The peripheral venous dose required to achieve atrioventricular block is higher than the central venous dose and the intraosseous dose is intermediary to the central venous and peripheral venous doses.
Getschman
S J
SJ
Division of Clinical Pharmacology/Toxicology, Ohio State University, Children's Hospital, Columbus.
Dietrich
A M
AM
Franklin
W H
WH
Allen
H D
HD
D000241:Adenosine / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D000293:Adolescent; D000818:Animals; D001283:Atrioventricular Node / Q000187:drug effects; D002304:Cardiac Pacing, Artificial; D002405:Catheterization, Central Venous; D002648:Child; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D004562:Electrocardiography / Q000187:drug effects; D006327:Heart Block / Q000139:chemically induced; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D017148:Infusions, Intraosseous; D007262:Infusions, Intravenous; D011897:Random Allocation; D013552:Swine; D013617:Tachycardia, Supraventricular / Q000188:drug therapy / Q000517:prevention & control
D000241:Adenosine