Association of Anaesthetists of Great Britain and Ireland

Although there were a few earlier attempts, it is generally accepted that the first public demonstration of the feasibility of general anaesthesia took place in Boston, USA, in October 1846. The agent was ether and, as the news spread, anaesthetics were soon administered in Britain, and in continental Europe. Surgeons soon realised that the use of anaesthetics allowed the scope of surgery to expand beyond being a treatment of last resort. Once the possibility had been demonstrated the search began for more pleasant and potent agents. Further inhalation agents were introduced, beginning with chloroform in 1847. Local anaesthetics were pioneered with the use of cocaine in eye surgery in 1884, followed by local infiltration, nerve blocks and then spinal and epidural anaesthesia. A further important innovation came in connection with the repair of facial wounds during World War One, with the control of the airway by a tube placed in the trachea, a technique that was elaborated and became standard after World War Two. The introduction of intravenous induction agents (barbiturates) avoided the unpleasantness of induction by inhalational agents. Muscle relaxants first came into use in the second half of the 1940s and improved agents were soon introduced. Drugs were developed with specific actions, so as to be more potent and less toxic. From the 1960s the range of the specialty developed beyond the operating theatre, so that its modern practitioners provide a range of care for patients, from consultation in the preoperative period to involvement in High Dependency and Intensive Care Units, emergency medicine, and acute and chronic pain management. Anaesthetics today forms the largest clinical specialty in the hospital sector of the National Health Service.

The Association of Anaesthetists of Great Britain and Ireland (AAGBI) was founded by Henry W Featherstone (1894-1967) of Birmingham (President of the Section of Anaesthetics of the Royal Society of Medicine, 1930-1931), who became its first President at the inaugural meeting at the premises of the Medical Society of London in 1932. It was founded at a period when specialist training in anaesthesia was virtually non-existent. One of the Association's objectives was to promote progress and safety in the practice of anaesthesia by improving the expertise, training and status of anaesthetists, so ensuring the safety and comfort of patients in the operating theatre. It now represents anaesthetists in the United Kingdom and the Republic of Ireland, and some overseas members, but although it is often consulted by government bodies it has no direct statutory powers. The maintenance of academic standards is the responsibility of the Royal College of Anaesthetists. At the time of its foundation the Association was the only representative organisation, and it played an important role in developments including the introduction of the first specialist qualification, the Diploma in Anaesthetics (DA) in 1935, and the expansion of the specialty during World War Two (1939-1945). Publication of its journal Anaesthesia began in 1946. It played a part in the founding of the Faculty of Anaesthesia of the Royal College of Surgeons of England (1947), which later became the Royal College of Anaesthetists. It was involved in negotiations about the status of the specialty preceding the inception of the National Health Service (1948); in the founding of the Faculty of Anaesthetists of the Royal College of Surgeons of Ireland (1959); and establishment of the Junior Anaesthetists' Group in 1967 (renamed the Group of Anaesthetists in Training in 1991). The Association holds scientific meetings and provides a forum for clinical and academic discussion; promotes and undertakes research; and promulgates its political views both independently and through the British Medical Association. In addition to the journal Anaesthesia it produces the newsletter Anaesthesia News. The Association was granted the right to bear arms by King George VI in 1945. The Association moved from its offices in the British Medical Association House, Tavistock Square, to new headquarters at no 9 Bedford Square, London, which was acquired in 1985 and opened in 1987. In 2002 its members numbered over 8,000.

The Association is headed by a Council, led by an elected President. Working Parties examine particular issues of relevance to the profession. The Association organises events, including seminars on professional issues as well as its Annual Scientific Meeting (yearly conference) and Winter Scientific Meeting. In addition to its journal it publishes guidelines on professional matters, and an annual report. It also makes grants, including research and travel grants, and awards, including medals and prizes. The Group of Anaesthetists in Training (GAT) caters for trainee anaesthetists, having its own committee, and specific seminars and Annual Scientific Meeting. The Linkman organisation was founded in 1974 as a means of transmitting information to and from AAGBI members. From 1976 Linkman meetings have been held annually, usually before the AGM and ASM. A Junior Linkman scheme was begun in 1985.

The Association administers the British Oxygen Company (BOC) Museum (A Charles King Collection of Historical Anaesthetic Apparatus), which originated with the collection of A Charles King (1888-1965), an engineer and instrument maker who specialised in anaesthetic apparatus from the early 1920s, a period of technical development in the specialty. Following a series of financial problems King's company was taken over by Coxeter's, which subsequently became part of the British Oxygen Company (BOC). King worked with leading anaesthetists in developing instruments and amassed a collection of equipment, which he donated to the Association of Anaesthetists in 1953 and which has subsequently been augmented by further acquisitions. The artefacts date from 1774 to the 1990s. The collection was moved from King's premises in Devonshire Street to the Royal College of Surgeons in 1965 and to the new premises of the Association of Anaesthetists at no 9 Bedford Square in 1987. The Association also rents accommodation at Bedford Square to other organisations including the Intensive Care Society and the Pain Society.

For further information, see Thomas B Boulton, The Association of Anaesthetists of Great Britain and Ireland 1932-1992 and the Development of the Specialty of Anaesthesia (Association of Anaesthetists of Great Britain and Ireland, London, 1999). On the history of anaesthesia see also the website of the History of Anaesthesia Society: http://www.histansoc.org.uk

The Royal College of Anaesthetists (RCA) is a separate organisation which has statutory responsibility for maintaining professional standards, which it does by the inspection of hospital departments and by examination for higher qualifications, the Diploma in Anaesthetics (DA), and its own Fellowship (FRCA).