title: Bidirectional modulation of isoflurane potency by intrathecal tetrodotoxin and veratridine in rats.
abstract: OBJECTIVE
  Results from several studies point to voltage-gated Na(+) channels as potential mediators of the immobility produced by inhaled anaesthetics. We hypothesized that the intrathecal administration of tetrodotoxin, a drug that blocks Na(+) channels, should enhance anaesthetic potency, and that concurrent administration of veratridine, a drug that augments Na(+) channel opening, should reverse the increase in potency.
  
  
  METHODS
  We measured the change in isoflurane potency for reducing movement in response to a painful stimulus as defined by MAC (minimum alveolar concentration of anaesthetic required to abolish movement in 50% of subjects) caused by intrathecal infusion of various concentrations of tetrodotoxin into the lumbothoracic subarachnoid space of rats, and the change in MAC caused by the administration of a fixed dose of tetrodotoxin plus various doses of intrathecal veratridine.
  
  
  RESULTS
  Intrathecal infusion of tetrodotoxin (0.078-0.63 microM) produced a reversible dose-related decrease in MAC, of more than 50% at the highest concentration. Intrathecal co-administration of veratridine (1.6-6.4 microM) reversed this decrease in a dose-related manner, with nearly complete reversal at the highest veratridine dose tested.
  
  
  CONCLUSIONS
  Intrathecal administration of tetrodotoxin increases isoflurane potency (decreases isoflurane MAC), and intrathecal administration of veratridine counteracts this effect in vivo. These findings are consistent with a role for voltage-gated Na(+) channel blockade in the immobility produced by inhaled anaesthetics.
authors.affiliation: Department of Anesthesiology, Fuwai Hospital and Cardiovascular Institute, Beijing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.forename: M
authors.initials: M
authors.lastname: Guzinski
authors.forename: E I
authors.initials: EI
authors.lastname: Eger
authors.forename: M J
authors.initials: MJ
authors.lastname: Laster
authors.forename: M
authors.initials: M
authors.lastname: Sharma
authors.forename: R A
authors.initials: RA
authors.lastname: Harris
authors.forename: H C
authors.initials: HC
authors.lastname: Hemmings
mesh_terms: D000280:Administration, Inhalation; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D000818:Animals; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D007103:Immobilization; D007263:Infusions, Parenteral; D007530:Isoflurane / Q000008:administration & dosage*; D008297:Male; D009043:Motor Activity / Q000187:drug effects*; D017288:Pain Threshold / Q000187:drug effects*; D051381:Rats; D020318:Rats, Long-Evans; D026941:Sodium Channel Blockers / Q000008:administration & dosage*; D015222:Sodium Channels / Q000187:drug effects* / Q000378:metabolism; D013779:Tetrodotoxin / Q000008:administration & dosage*; D014701:Veratridine / Q000008:administration & dosage*
chemical_list: D018685:Anesthetics, Inhalation; D026941:Sodium Channel Blockers; D015222:Sodium Channels; D013779:Tetrodotoxin; D014701:Veratridine; D007530:Isoflurane