Activity-dependent depression of neuronal sodium channels by the general anaesthetic isoflurane

Background The mechanisms by which volatile anaesthetics such as isoflurane alter neuronal function are poorly understood, in particular their presynaptic mechanisms. Presynaptic voltage-gated sodium channels (Na v ) have been implicated as a target for anaesthetic inhibition of neurotransmitter release. We hypothesize that state-dependent interactions of isoflurane with Na v lead to increased inhibition of Na + current ( I Na ) during periods of high-frequency neuronal activity. Methods The electrophysiological effects of isoflurane, at concentrations equivalent to those used clinically, were measured on recombinant brain-type Na v 1.2 expressed in ND7/23 neuroblastoma cells and on endogenous Na v in isolated rat neurohypophysial nerve terminals. Rate constants determined from experiments on the recombinant channel were used in a simple model of Na v gating. Results At resting membrane potentials, isoflurane depressed peak I Na and shifted steady-state inactivation in a hyperpolarizing direction. After membrane depolarization, isoflurane accelerated entry (τ control =0.36 [0.03] ms compared with τ isoflurane =0.33 [0.05] ms, P control =6.9 [1.1] ms compared with τ isoflurane =9.0 [1.9] ms, P I Na , during high-frequency stimulation of both recombinant and endogenous nerve terminal Na v . A simple model of Na v gating involving stabilisation of fast inactivation, accounts for this novel form of activity-dependent block. Conclusions Isoflurane stabilises the fast-inactivated state of neuronal Na v leading to greater depression of I Na during high-frequency stimulation, consistent with enhanced inhibition of fast firing neurones.