From Dental to Mental Institutions: A Quadruple Threat of Nitrous-Oxide Administration Before and During Mental Asylum Admission

  • Matthew L. Edwards
    Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd, Stanford, CA 94305-5717, USA
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  • George S. Bause
    Corresponding author at: 5247 Wilson Mills Rd, No. 282, Cleveland, OH 44143-3016
    Anesthesiology and Perioperative Medicine, Case Western Reserve University School of Medicine, 11100 Euclid Ave, Cleveland, OH 44106-6031, USA

    Oral and Maxillofacial Surgery, Case Western Reserve University School of Dental Medicine, 2124 Cornell Rd, Cleveland, OH 44106-3804, USA

    Honorary Curator and Laureate of the History of Anesthesia, Wood Library-Museum of Anesthesiology, American Society of Anesthesiologists, 1061 American Ln, Schaumburg, IL 60173-4973, USA
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Published:August 01, 2018DOI:


      • 100% nitrous-oxide anesthetic induction may have caused brain-damage in some patients.
      • More intraoperative 100% nitrous oxide doses may have relaxed muscles and damaged brains.
      • Dilute nitrous oxide could be used for mental-asylum diagnostics and/or therapeutics.
      • By the 1930s, some patients faced a quadruple threat of nitrous-oxide administration.


      During the 19th century, patients undergoing anesthesia for surgical and dental procedures were at risk of being given hypoxic or dilute nitrous oxide on four separate occasions. Primary and secondary saturation during surgery could account for two administrations of 100% nitrous-oxide anesthesia, while both diagnostic and therapeutic doses of dilute nitrous oxide were frequently administered in mental asylums.


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