Preferential location of lidocaine and etidocaine in lecithin bilayers as determined by EPR, fluorescence and 2H NMR.

We have examined the effect of the uncharged species of lidocaine (LDC) and etidocaine (EDC) on the acyl chain moiety of egg phosphatidylcholine liposomes. Changes in membrane organization caused by both anesthetics were detected through the use of EPR spin labels (5, 7 and 12 doxyl stearic acid methyl ester) or fluorescence probes (4, 6, 10, 16 pyrene-fatty acids). The disturbance caused by the LA was greater when the probes were inserted in more external positions of the acyl chain and decreased towards the hydrophobic core of the membrane. The results indicate a preferential insertion of LDC at the polar interface of the bilayer and in the first half of the acyl chain, for EDC. Additionally, (2)H NMR spectra of multilamellar liposomes composed by acyl chain-perdeutero DMPC and EPC (1:4 mol%) allowed the determination of the segmental order (S(mol)) and dynamics (T(1)) of the acyl chain region. In accordance to the fluorescence and EPR results, changes in molecular orientation and dynamics are more prominent if the LA preferential location is more superficial, as for LDC while EDC seems to organize the acyl chain region between carbons 2-8, which is indicative of its positioning. We propose that the preferential location of LDC and EDC inside the bilayers creates a "transient site", which is related to the anesthetic potency since it could modulate the access of these molecules to their binding site(s) in the voltage-gated sodium channel.

Spectrophotometric determination of etidocaine in pharmaceutical (dental) formulation.

A spectrophotometric method was developed for the determination of etidocaine hydrochloride (EH) in injectable pharmaceutical preparation. The proposal of this work was to develop a rapid, simple, inexpensive, precise and accurate visible spectrophotometric method. The method is based on the formation of the ion-pair complex by the EH reaction with bromocresol green in the pH 4.6 which after chloroform extraction gives a yellow color that in basic medium change to blue color and exhibits a maximum absorbance at 625 nm. The calibration graph was linear over the range 2.0-6.0 microg ml(-1) EH calculated on the final yellow solution. The R.S.D. of the slope of the four lines was 0.73%. This method can be applied to injectable pharmaceutical preparation dosage studied.

Structure-affinity relationships and stereospecificity of several homologous series of local anesthetics for the beta2-adrenergic receptor.

UNLABELLED: Local anesthetics inhibit binding of ligands to beta2-adrenergic receptors (beta2ARs), and, as a consequence, inhibit intracellular cAMP production. We hypothesized that among homologous local anesthetics, their avidity at inhibiting binding of tritiated dihydroalprenolol (3H-DHA) to beta2ARs would increase with increasing length of alkyl substituents and would demonstrate stereospecificity. Specific binding of 3H-DHA to human beta2ARs was assayed in the presence of six different members of the 1-alkyl-2,6-pipecoloxylidide class of local anesthetics (including mepivacaine, ropivacaine, and bupivacaine), the R(+) and S(-) bupivacaine enantiomers, lidocaine, prilocaine, etidocaine, procaine, and tetracaine. Avidity of binding to beta2ARs increased with increasing length of the alkyl chain (pKi values = 2.4, 3.6, 4.3, 4.1, 4.1, 5.9 for the methyl [mepivacaine], ethyl, S(-)propyl [ropivacaine], butyl [bupivacaine], pentyl, and octyl derivatives, respectively). We found no evidence for bupivacaine stereospecificity (pKi values = 4.3 and 4.9 for the S(-) and R(+) isomers, respectively). Other amide and ester local anesthetics also showed increasing potency with increasing length of alkyl substituents (pKi values = 3.6, 3.8, and 4.3 for lidocaine, prilocaine, and etidocaine; 4.2 and 5.6 for procaine and tetracaine, respectively). The correlation between increased inhibition of beta2AR binding and alkyl chain length resembles the correlation between local anesthetic potency at nerve block and increased alkyl chain length. The lack of clear stereospecificity is consistent with the relatively low potency these agents demonstrate at inhibition of beta2AR binding. Finally, the relatively potent inhibition of beta2ARs by etidocaine, tetracaine, and bupivacaine suggests that their propensity for cardiovascular depression after accidental intravenous overdose could result from beta2AR or beta1AR blockade and inhibition of cAMP production. IMPLICATIONS: Local anesthetics demonstrate a rank order of avidity for displacing ligands from beta2-adrenergic receptors such that larger molecules displace ligands at lower concentrations than smaller local anesthetic molecules. This relationship between molecular size and receptor avidity could explain the greater propensity for cardiovascular toxicity of relatively large local anesthetics such as bupivacaine.

On the mechanism by which bupivacaine conducts protons across the membranes of mitochondria and liposomes.

Bupivacaine and etidocaine possess the remarkable property of stimulating mitochondrial respiration to levels comparable with those observed with classical anionic protonophores (Dabadie, P., Bendriss, P., Erny, P., and Mazat, J.P. (1987) FEBS Lett. 226, 77-82). We show that these amphiphilic amines conduct protons across the membranes of mitochondria and liposomes and stimulate respiration by a true protonophoretic mechanism. The kinetics of drug-induced H+ flux exhibited integer Hill coefficients that were greater than two under all conditions, suggesting that multimers are required for H+ transport. When the energy barrier for ion transport was lowered in mitochondria, by increasing the membrane potential, or in liposomes, by adding phloretin, the Hill coefficients decreased to lower integer numbers. Protonophoretic activity depended exclusively on medium concentration of free base, leading us to conclude that bupivacaine and etidocaine conduct protons as associated, intramembrane multimers of the free base. Bupivacaine-induced H+ leak was ohmic rather than nonohmic, as would be expected of a mobile charged carrier. This kinetic behavior seems improbable for a multimeric mobile carrier mechanism and suggests a channel mechanism, in which ohmicity results from splitting of the energy barrier by energy wells along the transport pathway (Garlid, K. D., Beavis, A. D., and Ratkje, S. K. (1989) Biochim. Biophys. Acta 976, 109-120). We hypothesize that bupivacaine and etidocaine act by a novel "flickering channel" mechanism, in which transient linear complexes of free base molecules provide weak binding sites (energy wells) for protons within lipid bilayer membranes.

Long-acting local anesthetics in dentistry.

Long-acting local anesthetics have proved to be effective for the suppression of both intraoperative and postoperative pain. They are useful for lengthy dental treatments and for prevention of severe pain following many types of surgical procedures. Although the currently available long-acting local anesthetics for dentistry have minimal side effects in the doses usually employed, there are potential problems. Bupivacaine, for example, can cause significant cardiac depressant and dysrhythmogenic responses. Etidocaine has less pronounced effects on the cardiovascular system, but its use may be associated with inadequate control of intraoperative bleeding. A new long-acting local anesthetic, ropivacaine, appears to offer advantages over either of the currently used long-acting agents.

Effect of local anaesthetics on mitochondrial membrane potential in living cells.

Using the laser dye rhodamine 123, we demonstrated that local anaesthetics can reach mitochondria in cell culture and reversibly decrease, or even collapse, their transmembrane potential. This effect is highly dependent on the lipid-solubility of the local anaesthetic and can be facilitated by the presence of a lipophilic anion.