Pentobarbital blocks human cardiac sodium channels similarly to brain sodium channels, with the novel finding that channel block depends on electrolyte concentration.
May alter cardiac excitability during anesthesia; leaves open clinical relevance of electrolyte-dependent block in humans.
Background and objective To investigate the response to general anaesthetics of different sodium channel subtypes, we examined the effects of pentobarbital, a close thiopental analogue, on single sodium channels from human ventricular muscle and compared them with existing data from human brain channels. Methods Sodium channels from preparations of human ventricular muscle were incorporated into planar lipid bilayers in the presence of batrachotoxin, a sodium channel activator. Single channel currents were recorded in symmetrical 100 mmol L−1 and 500 mmol L−1 NaCl before and after the addition of the anaesthetic pentobarbital (0.34–1.34 mmol L−1). Results The blocking effect of pentobarbital on the fractional open time had an IC50 of 690 µmol L−1 in 500 mmol L−1 NaCl, whereas it had a significantly lower IC50 of 400 µmol L−1 in 100 mmol L−1 NaCl. Pentobarbital caused a significant shift of steady-state activation to hyperpolarized potentials (fmax = −42 mV, IC50 = 2 mmol L−1). This effect was independent of NaCl concentration. Conclusion Despite pharmacological and electrophysiological differences between human cardiac and human brain sodium channels their responses to pentobarbital are similar. The finding of channel block being dependent on the electrolyte concentration is novel for sodium channels.
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Wartenberg et al. (2001) studied this question.
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