Local anaesthetic block protects against electrically-induced damage in peripheral nerve

This study is one of a series addressing the mechanisms involved in the production of neural damage caused by continuous, prolonged electrical stimulation of peripheral nerve. It has been previously shown that sustained, high frequency electrical stimulation of the cat's peroneal nerve may cause irreversible neural damage in the form of axonal degeneration of the large myelinated fibres. In this study we demonstrate that blocking the action potentials on most of the nerve fibres with local anaesthetics (10% procaine or 2% lidocaine) almost completely prevents the axonal degeneration. The abolition of axonal injury by local anaesthetic block strongly suggests that the electrically-induced damage is due to prolonged electrical excitation of axons. Furthermore, since less than complete suppression of the induced neural activity by local anaesthetic engenders essentially complete sparing of all axons, our results suggest that the damage to individual axons derives, at least in part, from stimulation-induced global changes in the nerve.     

The pH-dependent rate of action of local anesthetics on the node of Ranvier

Local anesthetic solutions were applied suddenly to the outside of single myelinated nerve fibers to measure the time course of development of block of sodium channels. Sodium currents were measured under voltage clamp with test pulses applied several times per second during the solution change. The rate of block was studied by using drugs of different lipid solubility and of different charge type, and the external pH was varied from pH 8.3 to pH 6 to change the degree of ionization of the amine compounds. At pH 8.3 the half-time of action of amine anesthetics such as lidocaine, procaine, tetracaine, and others was always less than 2 s and usually less than 1 s. Lowering the pH to 6.0 decreased the apparent potency and slowed the rate of action of these drugs. The rate of action of neutral benzocaine was fast (1 s) and pH independent. The rate of action of cationic quaternary QX-572 was slow (greater than 200 s) and also pH independent. Other quaternary anesthetic derivatives showed no action when applied outside. The result is that neutral drug forms act much more rapidly than charged ones, suggesting that externally applied local anesthetics must cross a hydrophobic barrier to reach their receptor. A model representing diffusion of drug into the nerve fiber gives reasonable time courses of action and reasonable membrane permeability coefficients on the assumption that the hydrophobic barrier is the nodal membrane. Arguments are given that there may be a need for reinterpretation of many published experiments on the location of the anesthetic receptor and on which charge form of the drug is active to take into account the effects of unstirred layers, high membrane permeability, and high lipid solubility.     

Local anaesthetics and nodal polyanions in peripheral nerve

Synopsis Pantocaine, procaine, xylocaine and cocaine were found to interact with the polyanionic matrix surrounding the nodal axon membrane of peripheral myelinated nerve. Their affinity for nodal anionic sites was found to lie between that of mono- and divalent inorganic cations. The affinity was related to the polar character of local anaesthetic molecules. The possible significance of these interactions is discussed in terms of current theories regarding the action of local anaesthetics on nerve impulse conduction.     

The actions of phenol and pentachlorophenol (PCP) on axonal conduction, ganglionic synaptic transmission, and the effect of pH changes

1. A comparison of phenol, pentachlorophenol (PCP) and procaine effects on axonal conduction were studied in vitro in the sciatic nerves of toad. PCP and procaine were respectively 6.3 and 3.15 times more potent than phenol in blocking axonal conduction. 2. Effects of PCP on synaptic transmission were studied in vitro in the eighth sympathetic ganglion of toad. 3. Axonal conduction block and synaptic transmission block by phenol was reversible, but not that by PCP. 4. When the PCP ionization was increased, a lesser per cent reached the site of action, reducing its capacity to block the axonal conduction and ganglionic transmission. 5. PCP plus, 3,4-Diaminopyridine (3,4-DAP) decreased synaptic transmission block from post-ganglionic compound action potential (CAP) responses to supramaximal preganglionic stimulation.     

A non-archimedean theory of interaction of chemical compounds with membranes

The permeability of procaine across axon membranes and the effect of formaldehyde (FA), crotonic aldehyde (CA) and glutaraldehyde (GA) on the compound action potential of frog sciatic nerve was studied by utilizing a non-archimedean (NA) model of the relaxation process. Such models allow a characterization of biosystems exhibiting more than one time scale. Expansions using Laguerre polynomials have been obtained for relaxation functions. The new approach is tested by fitting the model to the experimental data of other authors, and then applying to extract molecular level information from macroscopic data.     

The effects of cations upon the action potentials recorded from neurohaemal tissue of the stick insect

Summary The ionic requirement for the action potentials recorded from the neurohaemal tissue on the lateral branch of the median nerve inCarausius morosus has been studied using extracellular electrodes. Sodium-free, magnesium-free, or calcium-free salines produce irreversible block of the action potentials following prolonged exposure to the nerves. Reducing the sodium concentration to 4 mM has little effect on the amplitude of the action potentials, whilst increasing the sodium concentration to 100 mM reduces the amplitude by 50%. Neither tetrodotoxin nor procaine has any effect on these action potentials.Reducing the magnesium concentration to 1 mM increases the amplitude of the action potentials, whilst increasing the concentration of magnesium reduces the amplitude.The amplitude of the action potentials is linearly related to the log of the external calcium concentration, and the action potentials are blocked by both cobalt ions and lanthanum ions.It is concluded that calcium is the major charge carrier of the inward current in these neurosecretory axons which is the first report of calcium dependent action potentials in a nerve axon. Furthermore, small amounts of sodium and magnesium are necessary to maintain electrical activity. Magnesium is a competitive inhibitor of the calcium currents.We are grateful to the Science Research Council for financial support, and to Mrs. J. Birch for the printing of the electron micrographs.     

Interaction of the cationic form of amphiphilic drugs with phosphatidylcholine model membranes. Competition with lanthanide ions

Model membranes (liposomes) of egg yolk phosphatidylcholine were exposed to the charged (cationic) form of amphiphilic drugs (procaine, tetracaine, metroprolol, alprenolol and propranolol). Drug analysis by ultraviolet light absorption of the bulk solution after centrifugation separation was used to determine the amount of drug bound to the membranes. Microelectrophoresis was employed to measure the change in the zeta-potential after drug adsorption. Binding constants were derived by simulating the experimental curves with a theoretical model which considers the electrostatic effects (Gouy-Chapman theory). Analogous experiments were carried out for the adsorption of Eu3+. Metal analysis was made by three different methods. Good agreement between the centrifugation and electrophoresis experiments was obtained for reasonable positions of the plane of shear relative to the positional plane of the bound ions. Displacement of Eu3+ from vesicles upon addition of drug cations was followed by 31P-NMR. The competition experiments were numerically simulated. The Eu3+ binding was assumed to obey a mass action type equilibrium, whereas the drug binding was described by a Henry's law partition. The binding constants for the drugs in the competition experiments followed the same order as in the absence of Eu3+. However, the numerical values had to be reduced. The effect of anions was studied.     

The modes of action of gallamine

The action of gallamine, a classical competitive neuromuscular blocking agent, has been examined on voltage-clamped endplates of frog skeletal muscle fibres. Gallamine produces a parallel shift of the equilibrium log (concentration)--response curves in concentrations of up to about 40 microM. At a membrane potential of -70 mV the Schild plot of the dose ratios so measured has a gradient of slightly less than the theoretical value, for a competitive antagonist, of unity. The apparent equilibrium constant for 'competitive' block is about 2 microM, and is approximately independent of the membrane potential. Fluctuation analysis of the endplate current shows two components in the presence of gallamine. The results can be fitted, over the range tested, by a mechanism that involves block of open ion channels by gallamine in a manner similar to that by procaine or quaternary local anaesthetic analogues. The rate constants for this action are strongly dependent on the membrane potential. At -100 mV the association rate constant is about 4 x 10(7) M-1S-1, the dissociation rate constant is about 600 s-1, and the equilibrium constant about 15 microM. Other kinetic measurements (voltage-jump relaxation, and nerve-evoked endplate currents) give results consistent with this conclusion, but apparently these results are valid over a range of conditions narrower than that for fluctuation analysis.     

Competitive Action of Calcium and Procaine on Lobster Axon : A study of the mechanism of action of certain local anesthetics

Voltage clamp studies with the squid giant axon have shown that changes in the external calcium concentration (Frankenhaeuser and Hodgkin, 1957) shift the sodium and potassium conductance versus membrane potential curves along the potential axis. Taylor (1959) found that procaine acts primarily by reducing the sodium and, to a lesser extent, the potassium conductances. Both procaine and increased calcium also delay the turning on of the sodium conductance mechanism. Calcium and procaine have similar effects on lobster giant axon. In addition, we have observed that the magnitude of the response to procaine is influenced by the external calcium concentration. Increasing external calcium tends to reduce the effectiveness of procaine in decreasing sodium conductance. Conversely, procaine is more effective in reducing the membrane conductance if external calcium is decreased. The amplitude of the nerve action potential reflects these conductance changes in that, for example, reductions in amplitude resulting from the addition of procaine to the medium are partially restored by increasing external calcium, as was first noted by Aceves and Machne (1963). These phenomena suggest that calcium and procaine compete with one another with respect to their actions on the membrane conductance mechanism. The fact that procaine and its analogues compete with calcium for binding to phospholipids in vitro (Feinstein, 1964) suggests that the concept of competitive binding to phospholipids may provide a useful model for interpreting these data.     

The modulation effects of d-amphetamine and procaine on the spontaneously generated action potentials in the central neuron of snail, Achatina fulica Ferussac

The modulation effects of d-amphetamine and procaine on the spontaneously generated action potentials were studied on the RP1 central neuron of giant African snails (Achatina fulica Ferussac). Extra-cellular application of d-amphetamine or procaine reversibly elicited bursts of potential (BoP). Prazosin, propranolol, atropine or d-tubocurarine did not alter the BoP elicited by either d-amphetamine or procaine. KT-5720 or H89 (protein kinase A inhibitors) blocked d-amphetamine-elicited BoP, whereas they did not block the procaine-elicited BoP. U73122, neomycin (phospholipase C inhibitors) blocked the procaine-elicited BoP, whereas they did not block the d-amphetamine-elicited BoP in the same neuron. These results suggest that BoP elicited by d-amphetamine or procaine were associated with protein kinase A and phospholipase C activity in the neuron.     

Selective procaine inhibition of rat chorda tympani responses to electric taste stimulation

1. The lingual treatment of 1% procaine for 10 min selectively suppressed responses of the rat chorda tympani nerve to anodal current applied to the tongue with NaCl in the bathing medium to about 50% of control but the drug produced no significant suppression in responses to chemical taste stimuli. 2. The magnitude of suppression of response to anodal current varied with concentration of procaine and kind of bathing medium for the current stimulation (larger in the order of NaCl greater than KCl greater than CaCl2 greater than HCl). 3. Such ion specificity in procaine suppression suggests that responses of the chorda tympani nerve to anodal current are provoked through the taste cell (not direct action on the taste nerve), and that the receptor mechanisms for anodal current are at least partly different from that for chemical taste stimuli.     

The penetration of local anesthetics into phosphatidylcholine monolayers.

The penetration of tetracaine into monolayers of phosphatidylcholine and trioctanoin at different surface pressures, and the penetration of dibucaine, tetracaine, butacaine, lidocaine, and procaine into monolayers of didecanoylphosphatidylcholine at II = 10 mN/m was determined by the use of a modified Gibbs adsorption equation. These data were shown to fit a geometric model and compared favorably with data determined by a method based on the geometric model. The penetration of tetracaine into phosphatidylcholine monolayers was pressure dependent. At II = 10 mN/m, the local anesthetics penetrate into a phosphatidycholine monolayer in the order: dibucaine greater than tetracaine greater than butacaine greater than lidocaine greater than procaine. This correlates with their potencies in blocking nerve conduction and inhibiting phospholipase A2.     

X-ray effects on single nerve fibers

Electrophysiological responses of median and lateral giant nerve fibers of the earthworm were recorded during exposure, in vitro, to x-rays. In response to external stimulation, during x-irradiation, these nerve fibers showed initially an increase in conduction velocity, a rise in spike amplitude, a decrease in relative refractory period, and an increase in sensitivity. These responses represent an enhancement of activity, attributable to bombardment with x-rays, rarely found in other biological systems. They were followed by deterioration of activity and eventual block, representative of the lethal action of x-rays, commonly observed in other biological systems. Several properties of the enhancement of activity were noted: The time at which maximum activity of one factor occurred did not coincide with the time at which the maxima of other activities occurred; spike amplitude, for example, was observed to increase while conduction velocity had already reached its maximum and was rapidly declining. The energy supplied by bombardment with x-rays did not act synergistically during the time of the enhanced response; that is, concomitant irradiation was not necessary in order to produce the enhanced response, once the nerve had been altered by x-irradiation. Once the nerve was responding in an enhanced manner, cessation of irradiation for short periods of time had no effect on the response. The phenomenon was therefore due to an irreversible alteration of the nerve fiber itself.     

Effects of strychnine on the sodium conductance of the frog node of Ranvier

Strychnine blocks sodium conductance in the frog node of Ranvier. This block was studied by reducing and slowing sodium inactivation with scorpion venom. The block is voltage and time dependent. The more positive the axoplasm the greater the block and the faster the approach to equilibrium. Some evidence is presented suggesting that only open channels can be blocked. The block is reduced by raising external sodium or lithium but not impermeant cations. A quaternary derivative of strychnine was synthesized and found to have the same action only when applied intracellularly. We conclude that strychnine blocks sodium channels by a mechanism analogous to that by which it blocks potassium channels. The potassium channel block had previously been found to be identical to that by tetraethylammonium ion derivatives. In addition, strychnine resembles procaine and its derivatives in both its structure and the mechanism of sodium channel block.     

Inhibition by capsaicin and its related vanilloids of compound action potentials in frog sciatic nerves

AimsAlthough capsaicin not only activates transient receptor potential vanilloid-1 (TRPV1) channels but also inhibits nerve conduction, the latter action has not yet been fully examined. The purpose of the present study was to know whether various vanilloids have an inhibitory action similar to that of capsaicin and further to compare their actions with that of local anesthetic procaine.Main methodsFast-conducting compound action potentials (CAPs) were recorded from frog sciatic nerve fibers by using the air-gap method.Key findingsCapsaicin reversibly and concentration-dependently reduced the peak amplitude of the CAP. TRPV1 antagonist capsazepine did not affect the capsaicin activity, and powerful TRPV1 agonist resiniferatoxin had no effect on CAPs, indicating no involvement of TRPV1 channels. Capsaicin analogs and other various vanilloids also inhibited CAPs in a concentration-dependent manner. An efficacy sequence of these inhibitions was capsaicin = dihydrocapsaicin > capsiate > eugenol > guaiacol ≥ zingerone ≥ vanillin > vanillylamine. Vanillic acid had almost no effect on CAPs; olvanil and curcumin appeared to be effective less than capsaicin. Capsaicin and eugenol were, respectively, ten- and two-fold effective more than procaine in CAP inhibition, while each of guaiacol, zingerone and vanillin was five-fold effective less than procaine.SignificanceVarious vanilloids exhibit CAP inhibition, the extent of which is determined by the property of the side chain bound to the vanillyl group, and some of them are more effective than procaine. These results may serve to unveil molecular mechanisms for capsaicin-induced conduction block and to develop antinociceptive drugs related to capsaicin.     

Action of Certain Tropine Esters on Voltage-Clamped Lobster Axon

Tropine p-tolylacetate (TPTA) and its quaternary analogue, tropine p-tolylacetate methiodide (TPTA MeI) decrease the early transient (Na) and late (K) currents in the voltage-clamped lobster giant axon. These agents, which block the nerve action potential, reduce the maximum Na and K conductance increases associated with membrane depolarization. They also slow the rate at which the sodium conductance is increased and shift the (normalized) membrane conductance vs. voltage curves in the direction of depolarization along the voltage axis. All these effects are qualitatively similar to those resulting from the action of procaine on the voltage-clamped axon. One unusual effect of the tropine esters, noticeable particularly at large depolarization steps, is that they cause the late, K current to reach a peak and then fall off with increasing pulse duration. This effect has not been reported to occur as a result of procaine action. Tropine p-chlorophenyl acetate (TPClA), which differs from TPTA only by the substitution of a p-Cl for a p-CH₃ group on the benzene ring, had a negligible effect on axonal excitability.     

Ankle extensor proprioceptors contribute to the enhancement of the soleus EMG during the stance phase of human walking

A rapid plantar flexion perturbation applied to the ankle during the stance phase of the step cycle during human walking unloads the ankle extensors and produces a marked decline in the soleus EMG. This demonstrates that sensory activity contributes importantly to the enhancement of the ankle extensor muscle activation during human walking. On average, the EMG begins to decline approximately 52 ms after the perturbation. In contrast, a rapid dorsi flex ion perturbation produces a group Ia mediated short-latency stretch reflex burst with an onset latency of approximately 36 ms. The transmission of sensory traffic from the foot and ankle was suppressed in 10 subjects by an anaesthetic nerve block produced with local injections of lidocaine hydrochloride. The anaesthetic block had no effect on the stance phase soleus EMG, the latencies of the EMG responses, or the magnitude of the EMG decline following the plantar flexion perturbation. Therefore, it is more likely that proprioceptive afferents, rather than cutaneous afferents, contribute to the background soleus EMG during the late stance phase of the step cycle. The large difference in onset latencies between the short-latency reflex and unload responses suggests that the largest of the active group Ia afferents might not contribute strongly to the background soleus EMG, although it remains to be determined which of the proprioceptive pathways provide the more important contributions.     

Procaine inhibits the erythroid differentiation of MEL cells by blocking commitment: Possible involvement of calcium metabolism

The action of procaine on the terminal erythroid differentiation of murine erythroleukemia (MEL) cells has been investigated at the level of individual cells. At concentrations (7 × 10^?4 M) which had no inhibitory effect on cell growth, pretreatment of these cells with procaine for 12–24 hr caused a pronounced inhibition (> 90%) of commitment to terminal erythroid differentiation of dimethyl sulfoxide (DMSO)-treated cells. Simultaneous treatment of MEL cells with DMSO and procaine, however, resulted to only slight inhibition (< 20%) of commitment. Blockade of commitment by procaine pretreatment appears to be general since it was observed in cells treated with other inducers (6-thioguanine, dimethylformamide). Procaine pretreatment did not abolish the ability of MEL cells to complete the “latent period” and commit upon the removal of the block. Reversal of procaine inhibition of commitment was obtained by the addition of either CaCl₂ (1.0 mM), calcium ionophore A23817 (1 μg/ml), but not of MgCl₂ (1.0 mM). From these data we conclude that procaine inhibits the terminal erythroid differentiation of MEL cells by blocking an event or process required for commitment which occurs prior to commitment itself. Our results suggest that this process involves calcium metabolism.     

Comparison of tetrodotoxin and procaine in internally perfused squid giant axons

Squid giant axons were internally perfused with tetrodotoxin and procaine, and excitability and electrical properties were studied by means of current-clamp and sucrose-gap voltage-clamp methods. Internally perfused tetrodotoxin was virtually without effect on the resting potential, the action potential, the early transient membrane ionic current, and the late steady-state membrane ionic current even at very high concentrations (1,000–10,000 nM) for a long period of time (up to 36 min). Externally applied tetrodotoxin at a concentration of 100 nM blocked the action potential and the early transient current in 2–3 min. Internally perfused procaine at concentrations of 1–10 mM reversibly depressed or blocked the action potential with an accompanying hyperpolarization of 2–4 mv, and inhibited both the early transient and late steady-state currents to the same extent. The time to peak early transient current was increased. The present results and the insolubility of tetrodotoxin in lipids have led to the conclusion that the gate controlling the flow of sodium ions through channels is located on the outer surface of the nerve membrane.     

Phrenic afferents and their role in inspiratory control

In anesthetized cats, with vagi cut and the spinal cord severed at the C8 level, phrenic motor and/or sensory discharge was recorded. Small afferent phrenic fibers were identified through their activation by lactic acid, hyperosmotic NaCl solution, or phenyl diguanide. They exhibited a spontaneous but irregular low-frequency discharge. Block of their conduction by procaine had no effect on eupneic motor phrenic activity. Large afferent phrenic fibers showed a spontaneous rhythmic discharge, and cold block (6 degrees C) of these fibers significantly prolonged the phrenic discharge time (Tphr) and total breath duration (TT) during eupnea. The stimulation of all afferent phrenic fibers lowered the impulse frequency of phrenic motoneurons (f impulses) and shortened both Tphr and TT. When the stimulation was performed during cold block all of the effects on phrenic output persisted, but changes in timing were less pronounced. Under procaine block, only the effects of phrenic nerve stimulation on Tphr persisted. These results suggest that both large and small afferent phrenic fibers control the inspiratory activity with a prominent role of small fibers on phrenic motoneuron impulse frequency.