History of NACCS (by Dr Peter Farling)

The History of NACCS

The Neuroanaesthesia Society was the first sub-specialist group of anaesthetists to be formed and in September 2025 it will have been in existence for 60 years. The Society was delighted that Dr. Jean Horton, one of the founder members, and many past-Presidents, including Dr. Stuart Ingram, attended the recent dinner in Manchester (May 2015).

In 2006 Dr Horton gave me the original minute book of the Neurosurgical Anaesthetists Travelling Club. I then obtained the minute book that had been maintained from 1981 by Dr Jim Jenkinson, the last Honorary Secretary of the Travelling Club. Information from these sources, and from Dr Horton’s article,1 has formed the basis of this short paper.

A number of eminent British and Irish neurosurgeons trained in North America during the 1920s. These included Mr Geoffrey Jefferson, Mr Norman Dott CBE and Sir Hugh Cairns, all of whom trained with Harvey Cushing in Boston. They returned to Manchester, Edinburgh and London respectively and brought with them the team model employed by Harvey Cushing (1869–1939).

Cushing had been profoundly influenced by his experience when, as a medical student, he was called from the ‘benches’ to administer ether. The patient promptly vomited, aspirated and died. His seniors told him ‘Don’t worry. This happens all the time! Cushing was one of the first clinicians to record the patient’s vital signs throughout surgical procedures. He appreciated the need for care when administering anaesthesia and was quoted as saying ‘regardless of the drug to be employed it is essential that it be employed by an expert – preferably by one who makes this his speciality’. On returning to London Sir Hugh Cairns adopted Cushing’s approach and persuaded the Rockefeller Foundation to provide funding for the first specialist neuro anaesthetists, Dr Olive Jones. She followed Cairns to Oxford when he moved there in 1938.

The National Health Service was formed in 1948 and anaesthetists obtained consultant status. By the 1960s neurosurgical units existed throughout Great Britain and Ireland and a number of anaesthetists specialised in anaesthesia for neurosurgery. However, the meetings and conferences of that time did not fulfil their academic needs. For example, the 131st Annual Meeting of the British Medical Association was held in Oxford in 1963. There was a section for anaesthetics and within that section, Professor Cecil Gray chaired a symposium on anaesthesia for neurosurgery. The speakers included Dr Norman McCleery from Sheffield, Dr Andrew Hunter from Manchester and Dr Jan Hewer from London.4 Dr Allan Brown from Edinburgh, who was the Honorary Secretary of the Scottish Society of Anaesthetists, began discussion groups for specialist anaesthetists. Neuroanaesthetists from Edinburgh, Glasgow, Aberdeen and Dundee met twice a year. In 1964 this Scottish group met in Newcastle and Dr Andrew Hunter,

Dr Hunter was in the Chair and papers were presented as follows:

1. Dr J Hewer: Hypothermia during neurosurgical anaesthesia
2. Dr V Campkin: Moderate hypothermia and circulatory arrest for operations on intracranial aneurysms
3. Dr N McCleery: Some aspects of anaesthesia for cerebral aneurysm
4. Dr D Potter: A comment on the use of ECG during Pudens shunts
5. Dr A Brown: The treatment of status epilepticus
6. Dr R Keen: Variations in venous pressure during controlled respiration