Timeline of important dates and events in the development of anaesthesia

This section chronologically presents some of the important dates and events in the development of anaesthesia.  It is by no means exhaustive.

c. 1150:

  • Nicholas of Salerno contributed a description of the soporific sponge to the Antidotarum Nicolai – the ingredients included opium and mandrake.

 
c. 1250:

  • Theodoric Borgognoni, Italian physician and bishop, described in his Cyrurgia, the use of sponges soaked with opium and mandragora for surgical pain relief – by his mentor/father, Hugo of Lucca.

 
c. 1275:

  • Raimundo Lulio (Lully/Lull), alchemist in Spain, is said to have prepared “oil of vitriol” – but this was forgotten for nearly 300 years and not named “ether” until 1730.

 
1540:

  • Valerius Cordus, apprenticed to Paracelsus, synthesized “sweet oil of vitriol” in Germany by distilling ethanol and sulphuric acid. Paracelsus then discovered the anaesthetic properties of this (not yet named diethyl ether) on chickens.

 
1628:

  • William Harvey publishes the first description of systemic circulation in Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus.

 
1730:

  • Frobenius originated the name “ether” by calling the sweet oil of vitriol “spiritus aethereus”.

 
1733:

  • Invasive arterial blood pressure measurement is described by Reverend Stephen Hales who inserted specially designed glass pipes into the carotid arteries of horses.  The non-invasive blood pressure cuff would be introduced by Scipione Riva-Rocci in 1896.

 
1743:

  • Charles-Marie de La Condamine prepares the first written account of curare in which it was described as 'flying death' that would 'kill in less than a minute'.

 
1744:

  • Physician John Fothergill published an account of mouth-to-mouth resuscitation to revive the apparently dead.

 
1771:                            

  • Joseph Priestley discovered “dephlogisticated air” which 8 years later would be called “oxygen”.  Among many other achievements, this Unitarian minister and scientist isolated nitrous oxide in 1772. Priestley wrote about his research on gases in 1774:  "I cannot help flattering myself that, in time, very great medicinal use will be made of the application of these different kinds of airs..."

 
1779:

  • Franz Anton Mesmer published his Memoire sur la decouverte du magnetisme animal, in which he described using magnets and hypnosis to cure various ailments. He received a grant from Louis XVI to study the magnetic influence of the stars on human beings.  'Mesmerism' was widely used for surgical pain relief prior to the introduction of anaesthesia.

 
mid-1780s:

  • James Watt, of workable steam engine fame, developed a partnership with Thomas Beddoes as Beddoes attempted to market his therapeutic applications of Priestley's "factitious airs" or gases. Watt developed equipment for Beddoes' use; some of this equipment was later used in Bristol during the nitrous oxide experiments of 1799 and 1800.

 
late 1780s:

  • Thomas Beddoes began to explore the potential medical uses of gases. He was assisted by James Watt, who developed some equipment for Beddoes' use.  In 1798 Beddoes founded the Pneumatic Institute in Bristol, England, where Humphry Davy did his nitrous oxide research.​


1790:

  • Dutch chemist Martinus van Marum became an active member of the Society of Dutch Chemists which studied gases – including nitrous oxide – and published some 35 papers based on that research up to 1808. He was also a member of the Academie Francaise and the Royal Society.

 
8th May 1794:

  • Antoine Laurent Lavoisier is beheaded in the early days of the French Revolution. It was Lavoisier who had experimentally shown the true nature of oxidation.  It is said that he had told his friends that he would start blinking as the guillotine blade fell and they were to see how long his eyes carried on blinking after his head was severed.  The result was some 15 seconds!

 
17th April 1799:

  • Humphry Davy wrote a letter which was published in Nicholson's Journal, announcing to the world that nitrous oxide can be inhaled by humans. "I have this day made a discovery," he wrote, "which, if you please, you may announce in your Physical Journal, namely that the nitrous phosoxyd or gaseous oxyd of azote, is respirable when perfectly freed from nitric phosoxyd (nitrous gas)."

 
mid-1799:

  • Dr Peter Mark Roget frequented the Pneumatic Institute in Bristol and was pressed by Davy to inhale nitrous oxide, to which he reacted violently. He recorded “I cannot remember that I experienced the least pleasure from any of these sensations”. However, in the majority who tried it, the inhalation induced laughter.  Roget wrote the Encylopaedia Britannica entry on Beddoes and in 1852 at the age of 70 he created his eponymous thesaurus.

 
25th June 1800:

  • Humphry Davy completes the introduction to his classic work, Researches, Chemical and Philosophical: Chiefly Concerning Nitrous Oxide, or Dephlogisticated Nitrous Air, and its Respiration. In the final book he suggested it might be used to relieve the pain of surgical operations.

 
1805:

  • Friedrich Wilhelm Adam Sertürner, a recently qualified apothecary, published a preliminary report on the active ingredient of opium, which he extracted. He named it ‘morphium’ after Morpheus, the Greek god of dreams. Later Joseph Gay-Lussac altered the term to ‘morphine’.                        

 
30th September 1811:

  • English novelist and diarist Fanny Burney undergoes a mastectomy for suspected breast cancer; she refused any drugs or alcohol. Between March and May 1812, Burney wrote a detailed letter describing her experience of surgery without anaesthesia.

 
21st February 1824:

  • Henry Hill Hickman writes a letter to T. A. Knight describing his experiments with painless surgery on animals using carbon dioxide as an anaesthetic.


12th April 1829:

  • Dr Jules Cloquet amputates a breast from a woman asleep under hypnosis.

 
1831:

  • Chloroform is first prepared.

 
1832:

  • Colt, calling himself "Professor Coult" or "Doctor Coult" of " Calcutta , London and New York ", toured the eastern United States giving demonstrations of nitrous oxide inhalation (laughing gas) to raise money to put his revolver prototype into production. In 1835 he patented a revolving-breech pistol and founded the Patent Arms Company in Paterson, New Jersey. The company failed in 1842, but an order for 1,000 revolvers by the U.S. government five years later during the Mexican War allowed Colt to restart his business.

 
January 1842:

  • In Rochester, New York, Trainee-Physician William E. Clarke administers ether from a towel to a Miss Hobbie prior to the removal of a tooth by dentist Elijah Pope. This was not published at the time.

 
30th March 1842:

  • Crawford W. Long in Jefferson, Georgia administers ether for the removal of a tumour from the neck of a Mr James M. Venable, in what is the first known administration of a gas for surgical pain relief.  However, Long did not publish an account of this until December 1849, when it appeared in the Southern Medical and Surgical Journal.

 
3rd June 1844:

  • First subcutaneous injection using a hollow needle is given by Francis Rynd in Dublin, Ireland. He published this in the following year.

 
Autumn 1844:

  • Dentist Horace Wells in Hartford, Connecticut experimented with painless extraction of teeth by the inhalation of nitrous oxide. This started with extraction of his own superior molar tooth by another dentist, Dr John M. Riggs.

 
10th December 1844:

  • Gardner Quincy Colton gave an exhibition in Hartford, Connecticut of the effects of inhaling nitrous oxide. This was attended by Horace Wells and he persuaded Colton to attend his surgery on the next day to administer nitrous oxide.  Later in the century Colton single-handedly revived interest in nitrous oxide for dentistry.

 
January 1845:

  • Horace Wells attempts to demonstrate anaesthetic properties of nitrous oxide at Massachusetts General Hospital.  The anaesthetic was incomplete and judged a failure.


30th September 1846:  

  • Boston dentist William Thomas Green Morton anaesthetizes Eben H. Frost and successfully removes an ulcerated tooth.  Frost had requested that Morton mesmerize (hypnotize) him, but the dentist, who had been searching for a pain-relieving agent, tried sulphuric ether instead.

 
16th October 1846:

  • On this Friday morning, William Morton appears in the operating theatre of the Massachusetts General Hospital (MGH).  Morton was running late, but surgeon John Collins Warren had not yet started the removal of a tumour from Gilbert Abbot's jaw.  For about 3 minutes Abbott breathed ether vapour from Morton's simple apparatus – which had been the source of his delay.  As Warren noted later, Abbott 'sank into a state of insensibility'.  The first successful public demonstration of ether anaesthesia had begun.  Abbott "did not experience any pain at the time, although aware that the operation was proceeding" Warren wrote in 1848.  The great surgeon is supposed to have declared "Gentlemen, this is no humbug."

 
17th October 1846:      

  • At the MGH surgeon George Hayward removes a large tumour from a woman's arm in the second successful demonstration of Morton's 'Letheon'.

 
7th November 1846:

  • Surgeon George Hayward performs a leg amputation and a lower jaw removal under ether anaesthesia at the Massachusetts General Hospital.  These surgeries were the 3rd and 4th at which the Boston dentist William Thomas Green Morton served as anaesthetist.

 
9th November 1846:

  • Henry J. Bigelow, junior surgeon at the Massachusetts General Hospital reports Morton's 4 successful ether anaesthetics to a meeting of the Boston Society for Medical Improvements.

 
12th November 1846:

  • Letter patent No. 4848 is issued to Charles T. Jackson and William T. G. Morton for 10% of all profits on the use of ether in surgical operations.  There was vociferous opposition from the medical and dental communities to such a patent so that Jackson and Morton quickly made their discovery known and freely available.

 
18th November 1846:  

  • Bigelow's account is published in the Boston Medical and Surgical Journal, launching the spread of ether anaesthesia around the world.


21st November 1846:    

  • In a letter to William T. G. Morton, Oliver Wendell Holmes suggests the word 'anaesthesia' to describe the mental state produced by the inhalation of the ether vapour.  The word had first appeared in Bailey's English Dictionary in 1751.

 
15th December 1846:

  • Ether anaesthesia is first administered in Paris, France.  The anaesthetic was administered by Francis Willis Fisher, a physician from Boston, Massachusetts for the excision of a large cancer on the lower lip of a 59 year-old man.

 
19th December 1846:    

  • English dentist James Robinson administers ether for removal of a diseased molar tooth from a young female patient in London.  John Snow visited Robinson within a few days to see the process at first hand. Also, ether is used for anaesthesia during the amputation of a leg in Dumfries, Scotland.

 
21st December 1846:

  • The first surgical anaesthetic with ether in England is administered by William Squire during surgery by Robert Liston. The operation was amputation through the thigh of Frederick Churchill’s leg.

 
19th January 1847:

  • James Young Simpson, Professor of Midwifery in Edinburgh, first uses ether for relief of pain in labour.

 
25th January 1847:

  • The first Caesarean section under general anaesthesia is performed at St. Bartholomew's Hospital, London.  The surgeon is Mr Skey and the anaesthetist Mr Tracy. The child survived but the mother, who was only four feet tall and had a grossly deformed pelvis, died two days after the operation.

 
28th January 1847:

  • John Snow begins to administer ether for major surgeries at St. George's Hospital, London.


February-March 1847:

  • French physiologist Marie Jean Pierre Flourens determines that inhalation of chloroform caused the same temporary state in animals as did ether. Flourens is best known for proving that the respiratory centre is in the medulla and the function of the cerebellum in muscular coordination; he also studied bone formation. He was a professor at the Collège de France for many years. In November 1847 Scottish physician James Young Simpson demonstrated the anaesthetic properties of chloroform in humans.

 
7th April 1847:

  • Nathan Cooley Keep administers the first obstetric anaesthetic in the United States in Cambridge, Massachusetts. Dr Keep was a prominent physician of the Boston area and the first Dean of Dentistry at Harvard. The patient was Frances Appleton Longfellow, second wife of Henry Wadsworth Longfellow. She later wrote about her experience, "I am very sorry you all thought me so rash and naughty in trying the ether. Henry's faith gave me courage...I feel proud to be the pioneer to less suffering for poor, weak womankind. This is certainly the greatest blessing of this age and I am glad to have lived at the time of its coming and in the country which gives it to the world..."

 
8th November 1847:

  • In Edinburgh, Scotland, James Young Simpson introduces chloroform into clinical practice.  The patient was Wilhelmina Carstairs, daughter of a physician.

 
28th January 1848:

  • Hannah Greener from Newcastle, England becomes the first fatality from chloroform anaesthesia to be widely reported in the literature.


1847-1848:

  • The weekly British humour magazine Punch, edited by Mark Lemon, published several items related to the newly discovered anaesthetics ether and chloroform. These items, which usually suggested unorthodox uses for the gases, included cartoons and such gems as Percival Leigh's song, "The Blessings of Chloroform."

 
1850:

  • First fire under ether anaesthesia is recorded.

 
7th April 1853

  • John Snow administers chloroform to Queen Victoria for the birth of her eighth child - Prince Leopold.  She later wrote in her journal  "Dr Snow gave that blessed chloroform and the effect was soothing, quieting and delightful beyond measure".  

 
end-1853:

  • Alexander Wood in Edinburgh married together the syringe and the hollow needle, thus facilitating hypodermic injection.

 
1854:

  • Manuel Patricio Rodriguez Garcia, a teacher of singing, discovered the use of mirrors to view the larynx. In 1855 he presented a paper on this to the Royal Society in London. This was the start of indirect laryngoscopy.

 
12th April 1856:

  • Dr Marshall Hall describes artificial respiration in The Lancet.

 
10th November 1856:

  • John Snow makes the first clinical administration of amylene, a gas he had extensively investigated in animals. By July 1857, Snow abandons use of the gas after two of his patients die. In the summer of 1857 a New York physician, John G. Orton, published two accounts in the Boston Medical and Surgical Journal of his use of amylene in a toenail extraction and an obstetric case. Dr Orton noted that he had obtained the amylene from Snow.


1858:

  • Dr Edward R. Squibb founded the Squibb Pharmaceutical Co. in a few rented rooms at 149 Furman Street in Brooklyn Heights, New York City. His company manufactured medicinal products that were safer, cleaner and more standardized than most of the medications then available. The company’s first order was for 18 pounds of chloroform. The firm’s specialty was anaesthetics, including ether, chloroform, and cocaine. By 1868 the company had outgrown its Furman Street quarters and eventually had more than 17,000 employees and marketed pharmaceutical products in 136 countries.

 
1859:

  • Karl von Scherzer brings first coca leaves to Europe – permitting isolation of cocaine.

 
1860:

  • Working at the University of Göttingen in Germany, Albert Niemann purifies cocaine.  

 
1862:

  • Thomas Skinner, a general practitioner and obstetrician from Liverpool designs the first wire frame for administration of open drop chloroform.  In 1890 Curt Schimmelbusch of Berlin introduced his more familiar wire-framed mask.

 
August 1868:

  • Joseph Thomas Clover presents his paper "On the Administration of Nitrous Oxide" at the British Medical Association meeting at Oxford.  Soon after Coxeter and Son in London begin marketing an apparatus employing a cylinder of gas, a reservoir bag and a Clover face mask.

 
November 1868:

  • Dr Edmund Andrews publishes in the Chicago Medical Examiner a paper proposing administration of nitrous oxide with oxygen in a premixed combination of 20% oxygen, 80% nitrous oxide.


December 1868:

  • A committee formed in April by the Odontological Society of Great Britain and the Committee of Management of the Dental Hospital of London to investigate nitrous oxide makes its first report.  The report recommended the elimination of air inhalation during nitrous oxide administration but also emphasizes the potential dangers of this method.

 
1st February 1873:

  • The Lancet reports the first documented death from nitrous oxide inhalation.

 
9th February 1874:

  • Pierre-Cyprien Oré administers the first intravenous general anaesthetic in humans in modern times.  In 1875 he published the first monograph on the technique, Etudes Cliniques sur L’Anesthésie Chirurgicale par La Methode des Injections de Chloral dans Les Veines. Acceptance of the method was delayed by slow recovery and high mortality.

 
1877:

  • Acetaminophen is first synthesised by Harmon Northrop Morse during a search for low-toxicity compounds of aniline.  The drug was abandoned in 1893 following clinical trials by Joseph von Mering who mistakenly claimed it produced methaemoglobinaemia.  The drug was first marketed as paracetamol in 1953.

 
1882:

  • August von Freund first synthesized cyclopropane.
  • Professor Sydney Ringer develops his solution for IV infusion.  In 1932 Dr Alexis Frank Hartmann added lactate to Ringer's solution to combat the possibility of acidosis in young patients –   Hartmann’s solution (Lactated Ringer's Solution).

 
15th September 1884:

  • A colleague of Dr Carl Koller reports to the Heidelberg Congress of Ophthalmology on Koller's first use of cocaine as a local anaesthetic.

 
15th November 1884:

  • Vassily von Anrep publishes first extensive account of the clinical use of cocaine in a Russian journal.


1884-85:

  • American surgeon William Stewart Halsted in New York described the first brachial plexus block using cocaine; this was a surgical technique (direct vision).  Unfortunately, his self-experimentation resulted in his addiction to cocaine, so that he was admitted to a psychiatric hospital in 1886. On discharge he had a changed personality and in 1987 he moved to the Johns Hopkins Hospital. Under his direction the first pair of rubber surgical gloves were made in 1889.

 
1st January 1886:

  • Wealthy grocer Thomas Edwin Bartlett dies in the Pimlico district of London from chloroform poisoning. In the spring his wife Adelaide and their spiritual advisor, friend and her lover, Wesleyan minister Reverend George Dyson, are tried and found innocent of the crime.

 
1891:

  • German physician Heinrich Irenaeus Quincke introduced the technique of lumbar puncture as a clinical procedure.

 
1893:

  • The Society of Anaesthetists is founded in London.  In 1908 the Society formed the Anaesthetic Section of the Royal Society of Medicine to advance the science and art of anaesthesia.

 
1894:

  • Harvey Williams Cushing and his fellow "house pup" at the Massachusetts General Hospital, E.A. Codman, developed the first anaesthetic record.

 
1895:

  • Alfred Kirstein of Berlin pioneered direct laryngoscopy.

 
March 1898:

  • At a meeting of the Society of Anaesthetists in England, Alfred Coleman describes his technique for nasal administration of nitrous oxide and Stephen A. Coxon advocates continuous insufflation of pure nitrous oxide into the pharynx.

 
April 1898:

  • Henry Hilliard describes induction of nitrous oxide anaesthesia with face mask and maintenance of anaesthesia with nasopharyngeal insufflation.

 
16th August 1898:

  • German surgeon Dr August Bier administers the first spinal anaesthetic.  During the First World War he was one of the designers of the German army helmet (“stahlhelm”, M16), which replaced the spiked helmet.

 
September 1898:

  • Bayer Company introduces heroin (diacetylmorphine, first synthesized in 1874), for use as a non-addictive painkiller.  It was later found to be more addictive than morphine and the company removed it from the market.


July 1900:

  • Oskar Kreis publishes the first account of spinal analgesia for vaginal delivery.

 
1901:

  • Cathelin and Sicard independently describe caudal analgesia.

 
23rd June 1902:

  • Frederick (later Sir Frederick) Hewitt anaesthetizes Edward VII for drainage of an appendix abscess.

 
1903:

  • Working at the Pasteur Institute, Ernest Fourneau develops the first synthetic local anaesthetic – amylocaine (Stovaine).
  • Ethyl chloride is popularised as a general anaesthetic.
  • The Electrocardiogram (ECG) is developed by Professor Willem Einthoven at the University of Leiden, Netherlands.

 
1904:

  • Alfred Einhorn develops procaine (Novocaine).

 
1907:

  • The first Intermittent Positive Pressure Ventilation (IPPV) device – the Draeger "Pulmotor" is introduced in Germany.

 
22nd February 1908:

  • Augustus D. Waller describes his chloroform balance at a meeting of the Physiological Society in London. This apparatus was the first to give a continuous and almost instantaneous reading of the concentration of vapour received by the patient.

 
1917:

  • Henry 'Cocky' Boyle designs his first anaesthetic machine.  This original Boyle machine was improved in a stepwise fashion between 1920 and 1965.


1919

  • Working at the Queen's Hospital for Facial and Jaw Injuries, Sidcup, Ivan Whiteside Magill used insufflation with two narrow gum elastic tubes, which he developed into a single, wider-bore red rubber endotracheal tube.  The following year he developed the forceps that became known throughout the world as Magill forceps.

 
April 1920:

  • Arthur Guedel published his first paper “Third stage ether anesthesia: a sub-classification regarding the significance of the position and movements of the eyeball”.

 
1922:

  • The first edition of Anesthesia and Analgesia is published under the auspices of the International Anesthesia Research Society.  Edited by Francis McMechan, this became the first dedicated journal of anaesthesia.

 
21st January 1923:

  • Arno B. Luckhardt administers the first ethylene-oxygen anaesthetic to J.B. Carter, a medical student. The experiment was repeated later the same day with Dr Luckhardt and Mr Carter exchanging roles. Since 1918 Luckhardt and R.C. Thompson had extensively studied the anaesthetic and analgesic properties of an 80/20 mixture of ethylene and oxygen in animals. Ethylene had been known for more than a century; in the late 1700s Joseph Priestley attributed its first preparation to Jan Ingenhousz, a Dutch botanist and physiologist. In 1849 British surgeon Thomas Nunneley investigated the gas, but he did not recommend it as an anaesthetic. In May 1923 Luckhardt and Carter reported on 106 cases of ethylene as a general anaesthetic. Ethylene continued in use clinically for some three decades, despite several explosions associated with its administration. In recent years ethylene has been suggested as the agent responsible for the exalted states associated with the ancient Oracle of Delphi.

 
7th April 1923:

  • First brain tumour operation under local anaesthesia is performed by Dr K. Winfield Ney at Beth Israel Hospital in New York City.

 
July 1923:

  • The British Journal of Anaesthesia is founded.  The BJA is the second oldest journal of anaesthesia and was the first to be published monthly (in 1955).  It became the journal of the College of Anaesthetists in 1990.

 
1931:

  • Cuffed endotracheal tubes are introduced into clinical practice.

 
1932:

  • The Association of Anaesthetists of Great Britain and Ireland is founded by Dr Henry Featherstone.  The Association adopted the motto 'in somno securitas' (safe in sleep) when it was granted the right to bear arms by King George VI in 1945.
  • Suxamethonium is first used by Dr Ranyard West to treat tetanus and patients with muscle spasticity.  Pethidine is introduced.  

 
1933:

  • Arthur Guedel designs a new 'non-traumatic pharyngeal airway'.  The Guedel airway remains in use worldwide today.

 
8th March 1934:

  • First use of thiopental in man – administered by Ralph M. Waters in Wisconsin.

 
1935:

  • Diploma in Anaesthetics (DA) examinations are introduced in Great Britain.


13th February 1936:

  • American Society of Anesthetists is founded as the new name of the New York Society of Anesthetists (founded 1911), formerly the Long Island Society of Anesthetists (founded 1905).  In 1945 the Society changed its name to the American Society of Anesthesiologists.

 
1937:

  • Thomas Philip Ayre invents a simple metal T-piece to which he attached 6-10 inches of open-ended red rubber tubing to the distal end as a reservoir for fresh gas flow.  Since there were no valves or reservoir bag, dead space and resistance to breathing were minimised.  In 1950 Jackson Rees added an open-ended bag to the expiratory limb that facilitated manual controlled ventilation.

 
23rd January 1942:    

  • Curare is introduced into anaesthetic practice by Canadian anaesthetist Harold Griffiths.

 
13th February 1943:

  • Sir Robert Macintosh publishes as article in Lancet about the laryngoscope blade that now bears his name.

 
1945:

  • The Tuohy epidural needle is introduced into clinical practice.

 
1946:

  • Anaesthesia, the journal of the Association of Anaesthetists of Great Britain and Ireland (AAGBI) is first published.

 
1947

  • Medical historian Dr Barbara Duncum published The Development of Inhalation Anaesthesia, which along with Thomas Keys' The History of Surgical Anesthesia is one of the major histories of the specialty.

 
October 1947

  • Two patients, Albert Woolley and Cecil Roe, receive spinal anaesthesia from the same anaesthetist, Dr James M. Graham, for relatively minor surgical procedures, and both developed permanent, painful, spastic paraparesis. The men sued Dr Graham and the Ministry of Health; the case finally went to trial in October 1953 and lasted eleven days. The plaintiffs lost primarily due to testimony of Sir Robert Macintosh. Despite the outcome, the use of spinal anaesthesia in the United Kingdom was retarded for the next 25 years.

 
1948:

  • Faculty of Anaesthetists of the Royal College of Surgeons of England is founded.
  • National Health Service is established in Great Britain.  Negotiation by the AAGBI ensured that anaesthetists received consultant status.
  • Torsten Gordh introduces lignocaine into clinical practice.

 
1949:

  • Virginia Apgar developed the scoring system for newborn evaluation that bears her name; she presented the system at a meeting on 21st September 1952, and published it the following year.

 
1952:

  • Intermittent Positive Pressure Ventilation (IPPV) is proposed by Dr Bjorn Ibsen – an anaesthetist working in Denmark during the polio epidemic.  Ibsen organising the continuous manual ventilation of patients by students and junior doctors.  

 
1953:

  • Halothane first synthesized.
  • Fellowship of the Faculty of Anaesthetists of the Royal College of Surgeons (FFARCS) examinations are introduced.  These became the Fellow of the College of Anaesthetists (FCAnaes) examinations in 1989 and Fellow of the Royal College of Anaesthetists (FRCA) examinations in 1992.


1954:

  • William Wellesley Mapleson, a physicist working in the Department of Anaesthetics at the Welsh National School of Medicine publishes his theoretical analysis of five semi-closed breathing systems.  Since he knew nothing of the origins of the systems, Mapleson simply applied the labels A, B, C, D and E.
  • Dr Henning Ruben designs the first prototype Ambu Bag using sprung bicycle spokes to aid automatic re-expansion.

 
1955:

  • World Federation of Societies of Anaesthesiologists is founded.

 
1956:

  • Halothane is first used clinically by Dr M. Johnstone in Manchester.

 
1957:

  • First Report on Confidential Enquiries into Maternal Deaths in England and Wales published.  It covered the years 1952-1954.

 
1959:

  • Faculty of Anaesthetists (now College) of the Royal College of Surgeons in Ireland is founded.

 
1960:

  • James B. Gormley of Pennsylvania described epidural blood patch to treat post-dural puncture headache (PDPH).

 
1961:

  • Brian Arthur Sellick publishes his seminal paper describing 'cricoid pressure to control regurgitation of stomach contents during induction of anaesthesia' in the Lancet.
  • Michael Tunstall in Portsmouth developed Entonox, produced by the British Oxygen Company.

 
1962:

  • Dr Leslie Rendell-Baker with dental surgeon Dr Donald Soucek developed a face mask for use in children that became a world-wide standard. Rendell-Baker was born in England, graduated from Guy's Hospital Medical School in 1941 and entered the Royal Army Medical Corps the following year to serve in the Second World War. After the war he trained in anaesthesia at Guy's Hospital and then settled permanently in the U.S. in 1957.  He co-authored three anaesthesia textbooks, 11 book chapters and numerous journal articles.


1963:

  • Edmond I. Eger II and Giles Merkel publish a study using the concept of Minimum Alveolar Concentration (MAC) to compare the effects of halothane and halopropane on physiological parameters in dogs.

 
1965:

  • Philip Raikes Bromage publishes his scoring system to assess the intensity of lower limb motor blockade after extradural analgesia/anaesthesia.
  • Ronald Melzack and Patrick D. Wall propose the gate control theory of pain. In 1984 they published the first edition of their Textbook of Pain.
  • Bupivacaine is first marketed by Astra Pharmaceuticals.

 
1970:

  • Intensive Care Society is founded in the UK.

 
August 1970:

  • Drs H.J.C. Swan and William Ganz of Los Angeles introduce the pulmonary artery catheter into clinical practice.

 
1972:

  • James Bain and Wolfgang Spoerel publish the first description of a coaxial 'streamlined anaesthetic circuit'.

 
1973:

  • John J. Bonica organized the first International Symposium on Pain in Seattle, leading to the creation in the same year of the International Association for the Study of Pain (IASP). Twenty years earlier, Bonica published the first edition of his classic The Management of Pain.
  • Etomidate is first used clinically.


1975:

  • Drs Wallace Ring, John Adair and Richard Elwyn of the University of Utah Primary Paediatric Hospital, Salt Lake City develop the RAE endotracheal tube.

 
1977:

  • Imperial Chemical Industries (ICI) formulate propofol with Cremophor EL.

 
1978:

  • Advanced Trauma Life Support (ATLS) – a trauma management system based on the concept of reducing morbidity and mortality in the 'Golden hour' following trauma first devised by physicians in Nebraska.

 
1980:

  • Archie Brain first develops the concept of the laryngeal mask airway having become disillusioned with endotracheal intubation.
  • First clinical use of atracurium.
  • In Sydney, Australia, Colin Sullivan and colleagues develop Continuous Positive Airway Pressure (CPAP) for the treatment of obstructive sleep apnoea.

 
1981:

  • Isoflurane is introduced into clinical use in North America.
  • In the USA, Biox Technology commercialise the first clinically useful pulse oximeter.

 
1983:

  • United Kingdom Resuscitation Council formed.

 
1984:

  • Propofol in soya oil emulsion is introduced into clinical practice.
  • Ronald Sidney Cormack and John Robert Lehane publish their landmark paper describing typical views during direct laryngoscopy.
  • Vecuronium is approved by the FDA.


1985:

  • Seshagiri Rao Mallampati and colleagues in Boston, Massachusetts publish their airway classification –  dividing patients into three groups according to which pharyngeal structures were visible.  In 1987 Samsoon and Young in Portsmouth, UK, added a fourth class.

 
1986:

  • The Harvard standards for patient monitoring during anaesthesia were published and adopted by the American Society of Anesthesiologists. This followed promotion of pulse oximetry, capnography and the oxygen/ nitrous oxide interlink by Jeffrey Cooper and Ellison Pierce of Boston, Massachusetts.  

 
1987:

  • First clinical use of desflurane.
  • First Confidential Enquiry into Perioperative Deaths (CEPOD) Report is published.  Commissioned jointly by the AAGBI and the Association of Surgeons of Great Britain and Ireland, it analysed 4000 deaths occurring within 30 days of surgery during 1986.  The first National Report (NCEPOD) was produced in 1989 and focused on deaths in children under 10 years of age.
  • Dr Jurgen Sprotte published the trial of the spinal needle that now bears his name.
  • The benzodiazepine antagonist flumazenil is first marketed by Hoffmann-La Roche.

 
1988:

  • College of Anaesthetists is founded replacing the Faculty of Anaesthetists of the Royal College of Surgeons of England.  A Royal Charter was granted in 1992.  The coat of arms of the Royal College of Anaesthetists (RCoA) features morphia poppy heads to symbolise general anaesthesia and analgesia and cocaine leaves to represent local anaesthesia.  The supporters on either side of the shield are John Snow and Joseph Thomas Clover.  Snow is depicted as a Doctor of Medicine of the University of London and has his early treatise On the inhalation of ether in surgical operations in his hand, whilst Clover holds his portable ether inhaler and is dressed in the robes of the Royal College of Surgeons of England.  The motto 'divinum sedare dolorem' means 'it is divine (or praiseworthy) to alleviate pain.
  • In Canada, David Gambling and colleagues introduce Patient Controlled Epidural Anaesthesia (PCEA).

 
1990:

  • Ondansetron is introduced into clinical practice as an antiemetic (5HT3 serotonin antagonist).  

 
1992:

  • Royal Colleges form the Joint Advisory Committee for Intensive Therapy (JACIT) to oversee training in intensive care medicine.


1993:

  • Drs E.P. McCoy and R.K. Mirakhur introduce the McCoy laryngoscope blade.

 
1994:

  • Intensive Care National Audit and Research Centre is established with funding from the Department of Health to undertake comparative audit and evaluative research in intensive care.
  • In the USA, Aspect Medical Industries develop Bispectral Index (BIS) Monitoring as a guide to depth of anaesthesia.

 
1995:

  • Sevoflurane is marketed for clinical practice by Abbott Laboratories.

 
1996:

  • Intercollegiate Board for Training in Intensive Care Medicine is formed (superseding the JACIT). The Royal College of Anaesthetists is lead institution.
  • Remifentanil is approved by the FDA.
  • Ropivacaine is marketed by Astra Pharmaceuticals.

 
1999:

  • First reviews are published recommending the routine use of ultrasound for regional nerve blocks and placement of central venous lines.

 
25th May 2000:

  • The first National Anaesthesia Day is held in Great Britain under the auspices of the Royal College of Anaesthetists.

 
2001:

  • The Glidescope becomes the first commercially available video-laryngoscope.


2003:

  • Datex-Ohmeda develops Spectral Entropy Monitoring as a guide to depth of anaesthesia.
  • Dr Richard W.D. Nickalls and Professor W.W. Mapleson develop age-related iso-MAC nomograms for isoflurane, sevoflurane and desflurane, as a guide to dosage and depth of anaesthesia.

 
2nd April 2007:

  • Faculty of Pain Medicine of the Royal college of Anaesthetists is founded.  The Faculty oversees the Fellowship of the Faculty of Pain Medicine of the Royal College of Anaesthetists (FFPMRCA) examinations.

 
25th July 2008:

  • The first selective relaxant binding agent, Sugammadex is approved for use in the  European Union.

 
June 2010:

  • Faculty of Intensive Care Medicine is founded by seven parent colleges – Royal College of Anaesthetists, College of Emergency Medicine, Royal College of Physicians of London, Royal College of Physicians of Edinburgh, Royal College of Physicians and Surgeons of Glasgow, Royal College of Surgeons of England and Royal College of Surgeons of Edinburgh.  The Faculty oversees the Fellowship of the Faculty of Intensive Care Medicine (FFICM) examinations.