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Visual Diagnosis in Emergency Medicine| Volume 54, ISSUE 5, e105-e107, May 2018

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Subacute Combined Degeneration from Recreational Nitrous Oxide Inhalation

  • Michael U. Antonucci
    Correspondence
    Corresponding Address: Michael U. Antonucci, md, Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas Street, MSC 323, Charleston, SC 29425
    Affiliations
    Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina
    Search for articles by this author
      Nitrous oxide (N2O) has been an anesthetic agent for more than 160 years and remains a pervasive agent today, particularly in dentistry (
      • Sun R.
      • Jia W.Q.
      • Zhang P.
      • et al.
      Nitrous oxide-based techniques versus nitrous oxide-free techniques for general anaesthesia.
      ,
      • Wilson S.
      • Gosnell E.S.
      Survey of American Academy of Pediatric Dentistry on nitrous oxide and sedation: 20 years later.
      ). Interestingly, its potential as a drug of abuse predates both its own clinical use and the advent of modern anesthesia (
      • Robinson D.H.
      • Toledo A.H.
      Historical development of modern anesthesia.
      ). Indeed, in 1799, the English chemist (and future Royal Society president) Humphry Davy began meticulously documenting the effects of inhaling N2O, noting “sublime emotion connected with highly vivid ideas” (
      • Davy H.
      Researches, chemical and philosophical: chiefly concerning nitrous oxide, or diphlogisticated nitrous air, and its respiration.
      ). After consuming progressively increasing amounts through a specially devised “breathing box,” he elected to share the intense derived pleasure with others. The recorded experience of these sessions, which included famed poets and other elite members of late 18th century British society, are now readily available (
      • Davy H.
      Researches, chemical and philosophical: chiefly concerning nitrous oxide, or diphlogisticated nitrous air, and its respiration.
      ,
      • The Public Domain Review
      The nitrous oxide experiments of Humphry Davy.
      ). Davy's contribution also includes experience of near-death overdose.
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