“…There is increasing evidence in animal models as well as cell culture preparations that general anesthetics also act presynaptically (van Swinderen et al, 1999;Metz et al, 2007;Herring et al, 2009Herring et al, , 2011Xie et al, 2013;Baumgart et al, 2015;Zalucki et al, 2015;Troup et al, 2019). Exactly how general anesthetics impair neurotransmission remains unclear, with isoflurane affecting presynaptic sodium and calcium channels (Koyanagi et al, 2019;Zhou et al, 2019) as well as SNARE formation (Xie et al, 2013;Troup et al, 2019); however, it is unknown whether intravenous and volatile agents might have common presynaptic effects. Work in rat neurosecretory PC12 cells showed that clinical concentrations of both propofol and isoflurane inhibit neurotransmission from these cells, and that coexpression of a mutant form of the presynaptic protein syntaxin1A preserves neurotransmission in these cells under anesthetic exposure (Herring et al, 2009(Herring et al, , 2011.…”