Meperidine and lidocaine block of recombinant voltage-dependent Na+ channels: Evidence that meperidine is a local anesthetic

Larry E. Wagner, Michael Eaton, Salas S. Sabnis, Kevin J. Gingrich

Research output: Contribution to journalArticle

69 Scopus citations

Abstract

Background: The opioid meperidine induces spinal anesthesia and blocks nerve action potentials, suggesting it is a local anesthetic. However, whether it produces effective clinical local anesthesia in peripheral nerves remains unclear. Classification as a local anesthetic requires clinical local anesthesia but also blockade of voltage-dependent Na+ channels with characteristic features (tonic and phasic blockade and a negative shift in the voltage-dependence of steady-state inactivation) involving an intrapore receptor. The authors tested for these molecular pharmacologic features to explore whether meperidine is a local anesthetic. Methods: The authors studied rat skeletal muscle μ1 (RSkM1) voltage-dependent Na+ channels or a mutant form heterologously coexpressed with rat brain Na+ channel accessory β1 subunit in Xenopus oocytes. Polymerase chain reaction was used for mutagenesis, and mutations were confirmed by sequencing. Na+ currents were measured using a two-microelectrode voltage clamp. Meperidine and the commonly used local anesthetic lidocaine were applied to oocytes in saline solution at room temperature. Results: Meperidine and lidocaine produced tonic current inhibition with comparable concentration dependence. Meperidine caused phasic current inhibition in which the concentration-response relationship was shifted to fivefold greater concentration relative to lidocaine. Meperidine and lidocaine negatively shifted the voltage dependence of steady-state inactivation. Mutation of a putative local anesthetic receptor reduced phasic inhibition by meperidine and lidocaine and tonic inhibition by lidocaine, but not meperidine tonic inhibition. Conclusions: Meperidine blocks Na+ channels with molecular pharmacologic features of a local anesthetic. The findings support classification of meperidine as a local anesthetic but with less overall potency than lidocaine.

Original languageEnglish (US)
Pages (from-to)1481-1490
Number of pages10
JournalAnesthesiology
Volume91
Issue number5
DOIs
StatePublished - Nov 1999

Keywords

  • Heterologous expression
  • Mutagenesis
  • Receptor

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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