INTRAOSSEOUS ADENOSINE - AS EFFECTIVE AS PERIPHERAL OR CENTRAL VENOUSADMINISTRATION

Objective: The purpose of this study was to determine if intraosseous administration of adenosine is effective and, if so, to establish ther apeutic dosage criteria for the intraosseous route compared with perip heral or central venous routes. Research Design: Randomized, unblinded , crossover, within-animal control study. Setting: University hospital in Ohio. Subjects: Thirty newly weaned piglets. Selection Procedure: Consecutive sample. Interventions: Thirty newly weaned pigs were trans esophageally (n=26) or transvenously (n=4) paced at a cycle length tha t was 10% longer than the Wenckebach threshold. The minimum effective dose of adenosine necessary to induce atrioventricular block during pa cing was recorded for peripheral venous, central venous, and intraosse ous routes. Measurements and Results: The baseline resting heart rate and Wenckebach thresholds were not statistically different between sub jects or between different routes of administration. The intraosseous route required a minimum effective dose of 127 mu g/kg. Using a log tr ansformation, the difference between central venous and peripheral ven ous doses was found to be statistically significant. The intraosseous dose was not statistically different from the central venous or periph eral venous doses. Conclusion: 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 p eripheral venous doses.