Molecular and physicochemical aspects of local anesthetic-membrane interaction

Local anesthesia is achieved by the binding of anesthetic molecules to the sodium channel, a membrane protein responsible for the transport of the extracellular sodium to the cytosol. Local anesthetics (LA) bind to the sodium channel inhibiting sodium transport and, as a consequence, the action potential responsible for the nervous impulse. Most LA are relatively hydrophobic ionizable amines that undergo partitioning into lipid. Both activity and toxicity correlate positively with LA hydrophobicity. Effects of LA on the structural and dynamical properties of the membrane lipid region may be responsible for some of the toxic effects caused by these molecules. The present review focuses on research done on the interaction between both the charged and uncharged forms of LA and lipid systems-bilayers and micelles. LA have been found to alter phospholipid gel to liquid crystal phase transition temperature (Tc), to affect bilayer permeability, to influence molecular packing, and to inhibit the bilayer to hexagonal phase transition. Anesthetics in micellized form disrupt bilayers giving rise to lipid-LA mixed micelle-like aggregates. The question of LA location in the bilayer is also addressed. Special emphasis is placed on work focusing on the quantitative analysis of drug binding, as well as on the effects of binding on physicochemical properties of the LA, such as extent of ionization (pK shifts) and rates of chemical reactions. The understanding of these phenomena has contributed to the development of less toxic liposomal formulations capable of prolonging the duration of anesthesia.