BJA SPECIAL RCoA 25^th ANNIVERSARY ISSUE November 2017 Landmarks in UK Anaesthesia

In this 25^th Anniversary year of the Royal College of Anaesthetists (RCoA), the Editorial Board of the British Journal of Anaesthesia (BJA) is proud to contribute this Special Issue of the journal to these important celebrations (see editorial by Hemmings & Hunter in the BJA: https://dbpia.nl.go.kr/bja/article-lookup/doi/10.1093/bja/aex370). This Special Issue is based on the RCoA Anniversary scientific meeting “Landmarks in UK Anaesthesia” held in March 2017 in London and organised by Dr Ramani Alladi and his colleagues at the RCoA. It highlights the significant contributions made by fellows of the College to the development of our speciality in the last 25 years. The topics covered at the meeting were wide-ranging and in this issue are divided into: cardiovascular; clinical practice; critical care; education; neuroscience; prehospital care; respiration and the airway; and translational research.

The issue opens with two special articles by international authorities on training future researchers in anaesthesia (Professor Kate Leslie, Australia), and improving the quality of patient care (Professor Carol Peden, USA). These were two of the main themes of the scientific meeting: teaching and improving patient safety. They are exemplified further in articles on the improvements in patient outcome after elective aortic aneurysm repair in recent years, and the importance of preoperative testing in optimising postoperative recovery. A surgical contribution highlights the role of anaesthetists in improving outcome after robotic surgery. The role of simulation in improving outcomes not only within hospital but also in prehospital care is stressed. Indeed, prehospital care is covered in detail in this issue with exciting contributions on the role of anaesthetists in global disasters, in warfare, and even in outer space! Improvements in postgraduate teaching and training are considered in depth, with some speculation on new roles for anaesthetists outside of the operating theatre.

Advances in clinical pharmacology receive detailed mention in this issue, reporting results from both laboratory and clinical research. The rapidly changing management of patients with cardiovascular disease in recent years is considered. Developments in the use of intravenous and inhalational anaesthetic agents are detailed, as is our increased understanding of the problems caused by residual neuromuscular block at the end of anaesthesia. The increasingly sophisticated approach to managing the airway throughout anaesthesia is highlighted. Conundrums are also addressed: we are still uncertain of the ideal management of intravenous fluid therapy perioperatively, and of how to prevent and treat postoperative cognitive dysfunction. The practice of critical care has changed immeasurably in the last 25 years bringing with it new and increasingly complex ethical challenges which are elaborated.

We trust you will enjoy reading the wide range of narrative reviews in this Special Issue which is freely available online. We thank the authors for their contributions to the future development of anaesthesia in its broadest sense and congratulate them on their continuing efforts. It has been a pleasure to compile this Special Issue and now to bring it to you.

Cover image

An evening photograph of the Royal College of Anaesthetists (RCoA), Red Lion Square, London. The RCoA held a scientific meeting in March 2017 entitled “Landmarks in U.K. Anaesthesia” to celebrate its 25th anniversary. This Special Issue is based on that meeting that focussed in particular on Patient Safety and Training in Anaesthesia.

Credit: the Royal College of Anaesthetists