The two faces of Eve: gaseous anaesthesia and inert gas narcosis.

Gaseous anaesthesia has been a great boon for medicine. These drugs form a foundation from which modern surgery has sprung, yet their mechanism(s) of actions remains poorly understood. Inert gas narcosis is a limitation of deep sea diving, and its mechanisms also remain poorly understood. In this review article we summarise what is known about the mechanisms of both gaseous anaesthesia and inert gas narcosis, including both lipid-based biophysical models and protein-based biochemical models, as well as explore some striking similarities between the two. These two phenomena may, in reality, be gradations of the same underlying mechanism. Recent findings include biochemical evidence suggesting that both gaseous anaesthesia and inert gas narcosis may be mediated by the occupation of minute spaces within the structure of many biologically important proteins, impairing their ability to undergo conformational changes and biological actions. This is exemplified by exploring the effects of the noble gas xenon, which can behave as either a narcotic gas or gaseous anaesthetic, depending on the partial pressure in which it is present.