Hypothesis
Volatile Anesthetics Produce Immobility by Acting on Two Sites Approximately Five Carbon Atoms Apart
- E. I Eger
- M. J. Halsey
- R. A. Harris
- D. D. Koblin
- A. Pohorille
- J. C. Sewell
- J. M. Sonner
- J. R. Trudell
All series of volatile and gaseous compounds contain members that can produce anesthesia, as defined by the minimum alveolar anesthetic concentration (MAC) required to produce immobility in response to a noxious stimulus.For unhalogenated n-alkanes, cycloalkanes, aromatic compounds, and n-alkanols, potency (1 MAC) increases by two-to threefold with each carbon addition in the series (e.g., ethanol is twice as potent as methanol). Total fluorination (perfluorination) of n-alkanes essentially eliminates anesthetic potency: only CF4 is anesthetic (MAC = 66.5 atm), which indicates that fluorine atoms do not directly influence sites of anesthetic action. Fluorine may enhance the anesthetic action of other moieties, such as the hydrogen atom in CHF3 (MAC = 1.60 atm), but, consistent with the notion that the fluorine atoms do not directly influence sites of anesthetic action, adding -(CF2)n moieties does not further increase potency (e.g., CHF2-CF3 MAC = 1.51 atm). Similarly, adding -(CF2)n moieties to perfluorinated alkanols (CH2 OH-[CF2]n F) does not increase potency. However, adding a second terminal hydrogen atom (e.g., CHF2-CHF2 or CH2 OH-CHF2) produces series in which the addition of each -CF2- "spacer" in the middle of the molecule increases potency two- to threefold, as in each unhalogenated series. This parallel stops at four or five carbon atom chain lengths. Further increases in chain length (i.e., to CHF2 [CF2]4 CHF2 or CHF2[CF2]5 CH2 OH) decrease or abolish potency (i.e., a discontinuity arises). This leads to our hypothesis that the anesthetic moieties (-CHF2 and -CH2 OH) interact with two distinct, spatially separate, sites. Both sites must be influenced concurrently to produce a maximal anesthetic (immobility) effect. We propose that the maximal potency (i.e., for CHF2[CF2]2 CHF2 and CHF2[CF2]3 CH2 OH) results when the spacing between the anesthetic moieties most closely matches the distance between the two sites of action. This reasoning suggests that a distance equivalent to a four or five carbon atom chain, approximately 5 Angstrom, separates the two sites. Implications: Volatile anesthetics may produce immobility by a concurrent action on two sites five carbon atom lengths apart.
(Anesth Analg 1999;88:1395-1400)
