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| === Anaesthetics (anesthetics), General [https://en.wikipedia.org/wiki/Anesthetic] === | | === Anaesthetics (anesthetics), General [https://en.wikipedia.org/wiki/Anesthetic] === |
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| ==== ❌ Nitrous oxide (N2O) (E942) [https://en.wikipedia.org/wiki/Nitrous_oxide] ==== | | ==== ✅Nitrous oxide (N2O) (E942) [https://en.wikipedia.org/wiki/Nitrous_oxide] ==== |
| <blockquote> | | <blockquote> |
| Nitrous oxide (aka laughing gas or nitrous) is the only anaesthetic in current use that is known to kill hookworms - and it may also kill whipworms, although this is not yet certain.
| | As a result of reports posted in the early days of the therapeutic use of NA, [https://groups.yahoo.com/neo/groups/helminthictherapy/conversations/messages/897] [https://groups.yahoo.com/neo/groups/helminthictherapy/conversations/messages/2137] [http://groups.yahoo.com/neo/groups/helminthictherapy/conversations/topics/2146] [https://groups.yahoo.com/neo/groups/helminthictherapy/conversations/topics/2174] nitrous oxide (aka laughing gas or nitrous) was assumed to kill hookworms. However, at least three people who have attempted to use nitrous oxide to deliberately kill their hookworm colonies have found that it was not effective. One subject reported inhaling “almost a full can of whipped cream” at 3 weeks post inoculation in an attempt to resolve severe side effects, but with no obvious effect on his hookworms. In another case, a ballon full of nitrous oxide failed to have any effect on a hookworm colony, some members of which were later confirmed by stool test to still be alive. [https://www.facebook.com/groups/htsupport/permalink/759492150773409/] Finally, in May 2017, someone tested the long-held assumption that N2O kills hookworms by inhaling a lot of nitrous oxide over the course of an hour, and reported that, although he got a headache and giggled a lot, none of his worms were harmed. [https://jasper-lawrence.com/2017/05/09/loss-of-efficacy-does-not-equate-to-loss-of-helminths/] |
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| Nitrous oxide is a weak general anaesthetic gas that is commonly administered throughout surgical operations
| | ✅ The following forms of nitrogen are also unlikely to be a problem for hookworms. |
| along with another powerful anaesthetic such as sevoflurane or propofol, although these latter two drugs are
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| effective alone, without nitrous oxide. Nitrous oxide might also be used at the end of surgery to keep a patient
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| unconscious while more potent anaesthetics clear from their system. The continued use of nitrous oxide during
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| surgery [http://www.sciencedaily.com/releases/2015/05/150531211135.htm has been questioned], and nitrogen, which will not harm helminths, is a [http://www.sciencedaily.com/releases/2015/10/151026093701.htm suitable alternative], but nitrous oxide remains popular, possibly because of its low cost.
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| Nitrous oxide may also be administered by paramedics, and during treatment in accident and emergency
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| departments, [http://www.bbc.co.uk/news/health-35716190] as well as being used as a propellant in cans of whipped cream and other cooking sprays. The
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| degree of concentration is likely to be important and the gas dissipates quickly in air, so, when using a nitrous
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| oxide-propelled cooking spray, just standing back for a moment after spraying should prevent any harm to one’s
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| worms. Alternatively, using a pump-action [https://www.youtube.com/watch?v=tE1SjyXHR4U oil mister] will completely remove any possibility of risk.
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| Consuming a small amount[http://groups.yahoo.com/neo/groups/helminthictherapy/conversations/topics/2160] of whipped cream that has been propelled by nitrous oxide will likely not adversely
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| affect hookworms, but eating a large amount[http://groups.yahoo.com/neo/groups/helminthictherapy/conversations/topics/2174] may. So, unless a large amount is eaten, or the cream is sucked, along
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| with some gas, directly out of the container, there's probably no need for concern.
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| Nitrous oxide was an ingredient in [http://publications.mcgill.ca/reporter/2014/06/beat-the-summer-heat-with-ice-cream-that-can-be-stored-at-room-temperature/ Frisson], a novel, sorbet-like ice cream in which the gas was used to create bubbles before the product was frozen at home. There was a flurry of media interest in this product in mid 2014, but it appears not to have been produced commercially.
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| The small quantities of nitrous oxide used as a filler in packs of potato chips and other snack foods has not been reported to present any risk to human helminths.
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| While several subjects have reported that just one whiff of nitrous oxide obtained directly from a whipped cream
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| dispenser has been sufficient to terminate a hookworm population (e.g., [http://groups.yahoo.com/neo/groups/helminthictherapy/conversations/topics/2146 here]) and its use as a [http://www.bbc.co.uk/news/uk-28710824 recreational drug] (for its euphoric and hallucinogenic properties) may also prove fatal to hookworms, at least three people who
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| attempted to use nitrous oxide to deliberately kill their hookworm colonies found that it was not completely
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| effective. One subject reported inhaling “almost a full can of whipped cream” at 3 weeks post inoculation in an
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| attempt to resolve severe side effects, but with no obvious effect on his hookworms. In another case, a ballon full of
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| nitrous oxide [https://www.facebook.com/groups/htsupport/permalink/759492150773409/ failed to have any effect] on a hookworm colony, some members of which were later confirmed to be
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| alive by stool tests.
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| Anyone who does lose their worms to nitrous oxide will [http://groups.yahoo.com/neo/groups/helminthictherapy/conversations/topics/2950 soon know that they are gone] because their disease
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| symptoms will return, typically within days or, at most, a couple of weeks after losing them.
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| ✅ Note that these other forms of nitrogen should not be a problem. The reaction of hookworms to nitrous oxide is extremely specific.
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| * Nitric oxide (NO) [http://en.wikipedia.org/wiki/Nitric_oxide] | | * Nitric oxide (NO) [http://en.wikipedia.org/wiki/Nitric_oxide] |
| * Nitrogen dioxide (NO2) [http://en.wikipedia.org/wiki/Nitrogen_dioxide] | | * Nitrogen dioxide (NO2) [http://en.wikipedia.org/wiki/Nitrogen_dioxide] |
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| * Pure nitrogen (N) [http://en.wikipedia.org/wiki/Nitrogen], [https://groups.yahoo.com/neo/groups/helminthictherapy/conversations/topics/6486 discussion] | | * Pure nitrogen (N) [http://en.wikipedia.org/wiki/Nitrogen], [https://groups.yahoo.com/neo/groups/helminthictherapy/conversations/topics/6486 discussion] |
| * Liquid nitrogen (LN2) [http://en.wikipedia.org/wiki/Liquid_nitrogen] | | * Liquid nitrogen (LN2) [http://en.wikipedia.org/wiki/Liquid_nitrogen] |
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| There is obviously something within the molecular structure of a hookworm that is a perfect fit for the nitrous oxide molecule, which either instantly locks on and kills the worm, or at least puts it to
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| sleep long enough to cause it to lose its grip on the intestinal wall and be flushed away.
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| We don't yet know for certain how susceptible whipworms are to nitrous oxide. Given that whipworms feed by
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| harvesting cells from their environment rather than drinking their host’s blood, it's possible that they are more
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| resistant to the gas, and there are suggestions that this may be the case. However, as nitrous oxide is likely to be
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| evenly distributed between intra and extracellular spaces, whipworms may come into contact with it as they graze,
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| so may still be affected to some extent, although perhaps less so than hookworms.
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| </blockquote> | | </blockquote> |
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| <blockquote> | | <blockquote> |
| Other gaseous anaesthetics may also be a problem for helminths because, while they might not kill them outright,
| | It has been suggested that the volatile organic compounds (VOCs) that were used in the early days of anaesthesia might be a risk to hookworms, especially if inhaled in excessive quantity, due to the possibility that they might stun them and cause them to be expelled from the gut before waking up. For example: |
| they may stun them, causing them to be expelled from the gut before waking up.
| | * ✅[http://en.wikipedia.org/wiki/Diethyl_ether diethyl ether] |
| | * ✅[http://en.wikipedia.org/wiki/Chloroform chloroform] |
| | However, a clinical scientist has reported that, while hosting both NA and TT, he worked around more organic solvents, including dichloromethane (CH2Cl2) and chloroform (CHCl3), than most people are exposed to in a lifetime, and that his hookworms and whipworms continued egg production uninterrupted. |
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| It has been suggested that the volatile organic compounds (VOCs) used in the early days of anaesthesia - e.g.
| | ✅ [http://en.wikipedia.org/wiki/Propofol Propofol] While propofol has been shown to adversely affect the mitochondria of roundworms in laboratory conditions, it is clear from the experience of hosts of both hookworms and whipworms that propofol does not harm human helminths in the concentrations used during surgery. |
| * ❌[http://en.wikipedia.org/wiki/Diethyl_ether diethyl ether]
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| * ❌[http://en.wikipedia.org/wiki/Chloroform chloroform]
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| might possibly also kill human helminths if taken in large enough quantity,
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| although other VOCs may not (see [[#VOCs|VOCs section]] below). However, a clinical scientist has reported that, while hosting human helminths, he
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| worked around more organic solvents, including dichloromethane (CH2Cl2) and chloroform (CHCl3), than most
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| people are exposed to in a lifetime, and that his hookworms and whipworms continued uninterrupted egg
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| production.
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| ✅ [http://en.wikipedia.org/wiki/Propofol Propofol] - Based on what is known currently, this injected anaesthetic (an ultrashort-acting sedative with amnesiac effects) appears to be the only worm-safe general anaesthetic. | | ✅ [http://www.sciencedaily.com/releases/2009/08/090804145614.htm Regional nerve blocks] are worm-safe. |
| While it has been shown to adversely affect the mitochondria of roundworms in laboratory conditions, it is clear from the experience of one host of both
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| hookworms and whipworms that propofol does not harm human helminths in the concentrations used during
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| surgery.
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| Additionally, propofol is likely to leave the patient with a clearer head, less nausea, and little or no sore throat.
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| Injected anaesthetics such as propofol may also be [http://www.sciencedaily.com/releases/2012/10/121026172943.htm safer], and [http://groups.yahoo.com/neo/groups/helminthictherapy/conversations/topics/6384 preferable] in children. This drug is even likely to be
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| safe in patients with food allergies [http://www.ncbi.nlm.nih.gov/pubmed/24447028], [http://www.ncbi.nlm.nih.gov/pubmed/26089466], and no connection has been found between allergy to propofol and
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| allergy to egg, soy or peanut [http://www.ncbi.nlm.nih.gov/pubmed/26675952], although [http://www.ncbi.nlm.nih.gov/pubmed/23275463 previous egg anaphylaxis may remain a contraindication].
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| Any worm host contemplating major surgery should discuss these issues with both their surgeon and anaesthetist
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| and may want to request intravenous-only general anaesthesia, which will involve the use of mostly propofol. It may
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| also be wise to request avoidance of any local anaesthesia with one of the "caine" drugs, which are often employed
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| to limit sympathetic response even when the patient is unconscious as a result of general anaesthesia. (see next section [[#localAnaesthetics|Anaesthetics (anesthetics), local]] for further discussion of the “caine” drugs).
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| ✅ [http://www.sciencedaily.com/releases/2009/08/090804145614.htm Regional nerve blocks] may provide a better alternative to general anaesthesia for helminth hosts in some cases,
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| [http://www.bbc.co.uk/news/uk-wales-10908414 especially for limb surgery].
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| </blockquote> | | </blockquote> |
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| <span id="localAnaesthetics"></span> | | <span id="localAnaesthetics"></span> |
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| === Anaesthetics (anesthetics), local [http://en.wikipedia.org/wiki/Anaesthetics] === | | === Anaesthetics (anesthetics), local [http://en.wikipedia.org/wiki/Anaesthetics] === |
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