Potential value of adenosine 5'-triphosphate (ATP) and adenosine in anaesthesia and intensive care medicine

Extracellular adenosine and adenosine triphosphate (ATP) areinvolved in biological processes including neurotransmission,muscle contraction, cardiac function, platelet function, vasodilatation,signal transduction and secretion in a variety of cell types.They are released from the cytoplasm of several cell types andinteract with specific purinergic receptors which are presenton the surface of many cells. This review summarizes the evidenceon the potential value and applicability of ATP (not restrictedto ATP–MgCl₂) and adenosine in the field of anaesthesiaand intensive care medicine. It focuses, in particular, on evidenceand roles in treatment of acute and chronic pain and in sepsis.Based on the evidence from animal and clinical studies performedduring the last 20 years, ATP could provide a valuable additionto the therapeutic options in anaesthesia and intensive caremedicine. It may have particular roles in pain management, modulationof haemodynamics and treatment of shock.