title: Comparative effects of halogenated inhaled anesthetics on voltage-gated Na+ channel function.
abstract: BACKGROUND
  Inhibition of voltage-gated Na channels (Na(v)) is implicated in the synaptic actions of volatile anesthetics. We studied the effects of the major halogenated inhaled anesthetics (halothane, isoflurane, sevoflurane, enflurane, and desflurane) on Na(v)1.4, a well-characterized pharmacological model for Na(v) effects.
  
  
  METHODS
  Na currents (I(Na)) from rat Na(v)1.4 alpha-subunits heterologously expressed in Chinese hamster ovary cells were analyzed by whole cell voltage-clamp electrophysiological recording.
  
  
  RESULTS
  Halogenated inhaled anesthetics reversibly inhibited Na(v)1.4 in a concentration- and voltage-dependent manner at clinical concentrations. At equianesthetic concentrations, peak I(Na) was inhibited with a rank order of desflurane > halothane approximately enflurane > isoflurane approximately sevoflurane from a physiologic holding potential (-80 mV). This suggests that the contribution of Na channel block to anesthesia might vary in an agent-specific manner. From a hyperpolarized holding potential that minimizes inactivation (-120 mV), peak I(Na) was inhibited with a rank order of potency for tonic inhibition of peak I(Na) of halothane > isoflurane approximately sevoflurane > enflurane > desflurane. Desflurane produced the largest negative shift in voltage-dependence of fast inactivation consistent with its more prominent voltage-dependent effects. A comparison between isoflurane and halothane showed that halothane produced greater facilitation of current decay, slowing of recovery from fast inactivation, and use-dependent block than isoflurane.
  
  
  CONCLUSIONS
  Five halogenated inhaled anesthetics all inhibit a voltage-gated Na channel by voltage- and use-dependent mechanisms. Agent-specific differences in efficacy for Na channel inhibition due to differential state-dependent mechanisms creates pharmacologic diversity that could underlie subtle differences in anesthetic and nonanesthetic actions.
authors.affiliation: Department of Anesthesiology, Weill Cornell Medical College, New York, New York 10065, USA.
authors.forename: Wei
authors.initials: W
authors.lastname: Ouyang
authors.forename: Karl F
authors.initials: KF
authors.lastname: Herold
authors.forename: Hugh C
authors.initials: HC
authors.lastname: Hemmings
mesh_terms: D018685:Anesthetics, Inhalation / Q000008:administration & dosage* / Q000737:chemistry; D000818:Animals; D016466:CHO Cells; D006224:Cricetinae; D003412:Cricetulus; D004305:Dose-Response Relationship, Drug; D054879:Halogenation; D009124:Muscle Proteins / Q000037:antagonists & inhibitors* / Q000502:physiology*; D015222:Sodium Channels / Q000502:physiology*
chemical_list: D018685:Anesthetics, Inhalation; D009124:Muscle Proteins; C466180:Scn4a protein, rat; D015222:Sodium Channels