Most general anesthetics produce two distinct actions at GABAA receptors. Thus, these drugs augment GABA-gated chloride currents (referred to as an indirect action) and, at higher concentrations, elicit chloride currents in the absence of GABA (referred to as a direct action). Because a /3 subunit appears to be required for the direct action of intravenous anesthetics in recombinant GABAA receptors, site-directed mutagenesis of the /33 subunit was performed to identify amino acid residues that are critical for this action. In HEK293 cells expressing a prototypical GABAA receptor composed of al/33y2 subunits, mutation of amino acid 290 from Asn to Ser dramatically reduced both etomidate-induced chloride currents and its ability to stimulate { 3H]flunitrazepam binding. By contrast, the ability of etomidate to augment GABA-gated chloride currents and GABA-enhanced [3H]flunitrazepam binding was retained. The demonstration that the direct, but not the indirect, actions of etomidate are dependent on /33(Asn290) indicates that the dual actions of this intravenous anesthetic at GABAA receptors are mediated via distinct loci. Key Words: Etomidate-Anesthetics-GABAA receptors-Chloride currents-Flunitrazepam. J. Neurochem. 69, 1310Neurochem. 69, -1313Neurochem. 69, (1997.Although the molecular targets responsible for anesthesia remain controversial (Franks and Lieb, 1994), the ability of intravenous anesthetics to affect GABAA receptor function has been recognized for over 15 years (Skolnick et al., 1980;Study and Barker, 1981;Leeb-Lundberg and Olsen, 1982). Both electrophysiological and neurochemical studies have shown that, within a clinically relevant concentration range, intravenous anesthetics such as pentobarbital, propofol, and etomidate produce two characteristic actions at GABAA receptors (Skolnick et al., 1981;Study and Barker, 1981;Sanna et al., 1995; Hill-Venning et al., 1997). Typically, at concentrations that have little or no effect on chloride currents, these agents augment GABA-gated currents. This effect, often referred to as an "indirect action," is also characteristic of other drugs with sedative/hypnotic properties [e.g., diazepam (Sigel et al., 1990) and phenobarbital (Schulz andMacDonald, 1981)1 that are by themselves not efficacious anesthetic agents. At higher concentrations, intravenous anesthetics have a direct action, increasing chloride conductance in the nominal absence of GABA (Study and Barker, 1981;Sigel et al., 1990), suggesting that this direct effect may be related to the process of anesthesia.There are often marked differences among brain regions in the action of anesthetics at GABAA receptors (Ashton et al., 1981;Harris et al., 1993), and such differences are likely to reflect the regional heterogeneity of GABAA receptors (Wisden et al., 1992). This hypothesis is consistent with studies in recombinant GABAA receptors demonstrating that subunit composition has a dramatic effect on drug action (Sigel et al., 1990;Luddens et al., 1994). For example, although both volatile and ...