A possible molecular mechanism for the pressure reversal of general anaesthetics: Aggregation of halothane in POPC bilayers at high pressure

We placed halothane, a general anaesthetic, inside palmitoyloleoylphosphatidylcholine (POPC) bilayers and performed molecular dynamics simulations at atmospheric and raised pressures. We demonstrated that halothane aggregated inside POPC membranes at 20 MPa but not at 40 MPa. The pressure range of aggregation matches that of pressure reversal in whole animals, and strongly suggests that this could be the mechanism for this effect. Combining these results with previous experimental data, we describe a testable hypothesis of how aggregation of general anaesthetics at high pressure can lead to pressure reversal, the effect whereby these drugs lose the efficacy at high pressure.