Psychotropic analgesic nitrous oxide
Psychotropic analgesic nitrous oxide (PAN) is a mixture of high concentrations of oxygen with relatively low concentrations of nitrous oxide (N2O or laughing gas). Dr Fred Lichtigfeld and Professor Mark Gillman working at SABRI (South African Brain Research Institute) introduced the term PAN to clearly distinguish those concentrations of nitrous oxide which produce psychotropic effects while the subject is fully conscious from the much higher concentrations of nitrous oxide that produce unconsciousness and anaesthesia. This distinction is of some practical importance because nitrous oxide is most commonly used for, and therefore associated with anaesthesia and unconsciousness. Nitrous oxide has been known since the late 18th century and was the first anaesthetic gas ever used in 1844. It has been employed ever since, mainly at anaesthetic concentrations, and is still probably the most commonly used of all anaesthetic agents currently used. In modern anaesthetic practice it is combined with other more powerful anaesthetic agents.
Over the last 60 or so years, it has been used, mainly in dentistry, for its analgesic rather than anaesthetic properties. When administered at psychotropic analgesic concentrations, the subject is always conscious, which avoids the necessity of observing the precautions always required for anaesthesia. At these low concentrations nitrous oxide interacts with the endorphin system in man and thus produces it psychotropic effects. We now know that the gas like other opioids (e.g. morphine and pethidine) also interacts with other neurotransmitters. Neurotransmitters are chemical messengers that are involved in transmitting messages from nerve to nerve. Because it is administered as a gas, it is rapidly absorbed through the lungs and reaches the brain within seconds, almost as swiftly producing observable changes. On the other hand, if it is discontinued, nitrous oxide is as quickly eliminated from the body. As a result of its rapid onset and offset of action and its effects on the endorphin system it allows the investigator to fine-tune the endorphin system in humans in both health and disease. This has given SABRI scientists a considerable advantage over other investigators in researching brain function directly in man, and permits almost complete avoidance of animal experiments.
The gases are administered with dental equipment (Matrx Medical or similar commercially available dental analgesia machine), which ensures that at least 30% oxygen is delivered to the patient. Should the flow of oxygen ever fall below 30% the nitrous oxide is instantly switched off by a fail-safe device, thus preventing anaesthesia or the possibility of delivering a mixture without a safe level of oxygen.
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