Anaesthesia and cosmetic surgery

  There has been a significant increase in the amount of cosmetic surgery undertaken in the UK over the past decade and although the greatest increases been in nonsurgical procedures such as fillers and Botox, the number of operations under general anaesthesia has also increased. The media has concentrated with some justification on whether patients… Read more »

Temperature control

  Temperature control during an operation is yet another of the many tasks that anaesthetists are responsible for. Temperature control has a number of benefits and also affects the patient in recovery so I thought it would be useful to include a blog   Humans are mammals and therefore maintain a very strict control over… Read more »

The difficult airway

  One of the most important jobs of an anaesthetist is maintaining the patient’s airway. As we lose consciousness, the tongue falls back and the airway becomes obstructed. In addition, anaesthetic drugs such as narcotics can suppress breathing. In some anaesthetics we deliberately stop the breathing so that we can relax the muscles to allow… Read more »

Sedation versus General Anaesthesia

  Advances in anaesthetic drugs mean many procedures can now be undertaken under sedation. Many patients find this decision quite difficult and I thought that a blog explaining the difference would be helpful.   General anaesthesia provides loss of consciousness or awareness together with pain relief. If you have a general anaesthetic you will be… Read more »


Hypertension or high blood pressure is very common and affects 16 million people in the UK. Often called the silent killer it has little effect for many years but can then cause heart attacks and strokes and is a major cause of death. It is very easy to measure and in most patients easy to… Read more »


When we talk about blood-borne infections we mean hepatitis and HIV where the concern is that patients carrying these viruses are asymptomatic and unaware that they are carriers. The relevance to me as an anaesthetist is protecting my staff. We practice what is called universal precautions which means effectively we treat patients as if they… Read more »

Healthy Living

This is the third and final part of my trilogy of blogs on preventative medicine. The other two are titled over-the-counter drugs and screening. Promoting healthy living has become an industry but like vitamins and minerals which are too often 21 st -century snake oil there is a lot of fake news. So what can… Read more »

Apoptosis – injury to the brain

  I am often asked by patients if an anaesthetic, or repeated anaesthetics, cause long-term harm. The simple answer is no. The risk of an anaesthetic is very low and if you have no other medical problems the risk of ANY catastrophic complication is 1 in 83,000 – about the same risk as being knocked… Read more »

Anesthesia and Cancer

As other illnesses have become less frequent and we have become better at treating them, cancer has become the most common reason for needing general anaesthesia. Advances in radiotherapy and chemotherapy, many originating from my own hospital St Bartholomews in London, together with surgery remain the mainstay of treatment although immunotherapy and genetics offer exciting… Read more »


Every patient admitted to the hospitals in which I work is asked to complete an audit form. These are analysed and ranked by an independent company and provide valuable insight into how well we are performing. One of the commonest issues raised is the admission process and although this is not directly related to my… Read more »