Guide to Nitrous Oxide/Oxygen Minimal Conscious Sedation or PAN Sedation: Theoretical Basis of Practice. By Dr Mark A. Gillman
This nitrous oxide course (laughing gas) is a comprehensive, clear textbook/ workshop manual giving the theoretical knowledge on how to use PAN also known as minimal sedation with nitrous oxide/oxygen for medical and dental applications
· It is particularly useful for minor medical and dental procedures which are accompanied by anxiety and/or pain.
· It has applications in medicine for treatment of acute substance abuse withdrawal states and for diagnostic and therapeutic use in other neuropsychiatric conditions such as depression.
· The basic slide format with commentary enables practitioners to proceed at their own pace absorbing the essential theory and once they have done so, rapidly learn the practical technique during hands-on training.
PAN is also known as inhalation sedation or relative analgesia. This nitrous oxide course (laughing gas) aims to give physicians, dentist and suitably qualified nurses the theoretical basis on which the technique is based. Like any surgical procedure replace hands-on training which takes no more that 2-3 hours to acquire practical skills once the practitioner is thoroughly familiar with the theoretical aspects, which are given in sufficient detail in the presentation to enable trainees to rapidly be taught to administer the gases practically. The training must be done with either a dental practitioner who is experienced with the technique of PAN in their daily practice or some other registered practitioner who is also well-schooled in the use of nitrous oxide/oxygen minimal sedation. Anaesthesiologists are not usually suitable because practitioners to teach PAN sedation, because they normally use much higher concentrations of nitrous oxide for anaesthesia and seldom use PAN in their practices. The crucial difference is that during anaesthesia the subject is unconscious, while during PAN sedation the consciousness of the subject is little obtunded so that they can readily understand and comply with verbal instructions. For those interested, Dr Gillman is available to train practitioners in South Africa or anywhere else in the world. He can be contacted at firstname.lastname@example.org.
This current 4th edition is largely based on the previous editions, which had a similar title which has been successfully sold in South Africa and the rest of Africa as well as various countries in Europe and elsewhere. In South Africa, it has been allocated 8 continuing professional development. It has 6 sections:
1.Introduction and definition – gives some back ground
2. Physiology & Pharmacology of PAN
Lecture 2 Part 1 Introduction to Pharmacology & Physiology of PAN
Lecture 2. Part 2 Pharmacology & Physiology of PAN Continued
3. Advantages of PAN sedation for Patient & Doctor
4. Practical Aspects
5. Ethical use of PAN
6. Financial viability
These 6 sections cover the following:
Other terms commonly used for PAN;
Overview of Clinical Uses of Nitrous Oxide/Oxygen Sedation;
Concept of Anxiety and Pain;
Basic Physiology of Pain and the Endogenous Opioid System and physiological basis of the pain-pleasure continuum;
Nitrous oxide interactions with the Endogenous opioid system and this relationship to Pain and Anxiety Control;
Methods of Pain & Anxiety Management and Nitrous Oxide/Oxygen Sedation;
Differences between Nitrous Oxide/Oxygen Sedation and General Anaesthesia;
Physical & Chemical Properties in relation to Nitrous Oxide/Oxygen Sedation;
Clinical Respiratory Anatomy Physiology & Nitrous Oxide/Oxygen Sedation;
Pharmacology of Nitrous Oxide/Oxygen Sedation;
Practical Aspects of Nitrous Oxide/Oxygen Sedation;
a. Patient Assessment
b. Importance of Titration
c. Monitoring Patient
d. Patient Involvement
e. Endpoint/Comfort Zone (Ethics of using correct concentration)
f. Terminating Administration
g. Patient Recovery
h. Customised Equipment
i. Using PAN to treat acute substance abuse withdrawal states
j. Ethical responsibilities.
k. Ethical prudent practice guidelines
l. Ethical practise building and profit aspects
m. Pollution control as an ethical and legal responsibility
n. Financial aspects and benefits