Clinical and physiological rationale and methodology for the use of medical xenon in the complex treatment of pain syndrome in osteoarthritis: a review

Vollständiger Abstract

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INTRODUCTION. This review presents an in-depth analysis of the use of medical xenon as a universal agent in modern anesthesiology and therapeutic practice. Particular attention is paid to the use of xenon for the management of chronic pain syndrome in osteoarthritis, where adverse effects and insufficient analgesic efficacy often limit traditional pharmacotherapy. A high safety profile, the absence of systemic toxicity, and the ability to modulate central sensitization make this inert gas a promising component of multimodal analgesia. AIM. To analyze the clinical application of medical xenon and substantiate its efficacy and safety in the treatment of pain syndrome in patients with osteoarthritis based on a systematic review of the literature. MAIN CONTENT OF THE REVIEW. This review was prepared through a systematic search and critical analysis of international literature focusing on the physicochemical properties, pharmacodynamics of medical xenon, and its clinical application in anesthesiology and the management of pain syndromes in osteoarthritis. Relevant publications were identified in Russian and international databases, including eLIBRARY.RU, PubMed, Scopus, and Google Scholar. The search period covered studies from the earliest fundamental research on inert gases (1898) to contemporary clinical guidelines and multicenter trials (2025). The paper examines the physicochemical determinants and molecular mechanisms of action of this inert gas, including its effects on NMDA receptors and metabotropic complexes. The stages of xenon anesthesia are described in detail, and its high safety profile in geriatric and pediatric populations is substantiated. Particular attention is given to an innovative method for managing pain syndromes in patients with osteoarthritis through local para-articular injections of highly purified xenon. The presented clinical experience demonstrates a significant reduction in pain intensity according to the Visual Analog Scale (VAS), along with prolonged analgesic effects in the absence of systemic toxicity. The use of specialized equipment enables optimization of dosing regimens and minimization of adverse effects, thereby opening broad prospects for the use of xenon therapy in the rehabilitation of patients with degenerative joint diseases and in reducing disability rates. CONCLUSION. Available data suggest that xenon can be considered a promising component of multimodal analgesia in patients with osteoarthritis. However, further randomized controlled trials specifically focused on this patient population are required, particularly to assess long-term efficacy and the impact on the neuropathic component of pain.