Adenosine: an old drug newly discovered

Anesthesiology. 2009 Oct;111(4):904-15. doi: 10.1097/ALN.0b013e3181b060f2.


Over decades, anesthesiologists have used intravenous adenosine as mainstay therapy for diagnosing or treating supraventricular tachycardia in the perioperative setting. More recently, specific adenosine receptor therapeutics or gene-targeted mice deficient in extracellular adenosine production or individual adenosine receptors became available. These models enabled physicians and scientists to learn more about the biologic functions of extracellular nucleotide metabolism and adenosine signaling. Such functions include specific signaling effects through adenosine receptors expressed by many mammalian tissues; for example, vascular endothelia, myocytes, hepatocytes, intestinal epithelia, or immune cells. At present, pharmacological approaches to modulate extracellular adenosine signaling are evaluated for their potential use in perioperative medicine, including attenuation of acute lung injury; renal, intestinal, hepatic and myocardial ischemia; or vascular leakage. If these laboratory studies can be translated into clinical practice, adenosine receptor-based therapeutics may become an integral pharmacological component of daily anesthesiology practice.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adenosine / metabolism
  • Adenosine / pharmacology
  • Adenosine / therapeutic use*
  • Anesthesia*
  • Animals
  • Cardiovascular Agents / pharmacology
  • Cardiovascular Agents / therapeutic use*
  • Extracellular Space / metabolism
  • Humans
  • Hypoxia / metabolism
  • Intraoperative Complications / diagnosis
  • Intraoperative Complications / drug therapy*
  • Intraoperative Complications / physiopathology
  • Perioperative Care*
  • Signal Transduction / physiology
  • Tachycardia, Supraventricular / drug therapy
  • Tachycardia, Supraventricular / physiopathology


  • Cardiovascular Agents
  • Adenosine