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Richard Gordon (1921–2017) was a prolific writer of both humorous fiction and historical reviews. He trained in medicine at St Bartholomew’s Hospital (Barts) in London and specialised in anaesthesia working at Hill End Hospital, St Albans (where a large proportion of Barts work took place to avoid the impact of the Blitz during the Second World War) and at the Radcliffe Infirmary, Oxford with Robert Macintosh. He published multiple papers and a book on trichlorethylene anaesthesia and edited a textbook of anaesthesia for medical students which ran for 10 editions. His gift for writing and his prominent public persona placed him in a unique position to highlight the importance of the newly emerging speciality of anaesthesia. He did the exact opposite of this and instead created a representation of an uninterested spectator to surgical activity, a representation which still persists in some quarters today.

Purpose: Laparoscopy is the gold standard to assess for presence of an intra-abdominal testis. However, techniques for the subsequent orchidopexy vary, and include the recently described staged laparoscopic traction orchidopexy (SLTO) (Shehata in Pediatr Surg 51(2):211–215, 2016). SLTO enables elongation of the testicular vessels without division, with initial success rates reportedly superior to Fowler–Stephens. We present the first UK data following a preliminary study using SLTO. Methods: 19 boys prospectively presenting with 22 intra-abdominal testes (IAT) underwent STLO in a single centre, with a median age of 2.5 years (IQR 1.4–5.2) at first stage. 3/19 (16%) boys had bilateral IAT and nine (41%) were left-sided. Pneumoperitoneum was established using 5 mm umbilical and 3 mm accessory ports in bilateral iliac fossae. The gubernaculum and lateral peritoneal attachments were divided prior to securing the intra-abdominal testis to the contralateral anterior abdominal wall with 2/0 Ti-cron™. Second-stage procedures were planned for 3–6 months later. The securing stitch was cut; an 11 mm STEP port was placed trans-scrotally to retrieve the testis and secured in a sub-dartos pouch. Outcome measures included palpable testes in the scrotum and surgical complications. Results: 13/22 IAT have undergone follow-up. Twelve (92%) IAT were palpable in the scrotum following SLTO. There was one diathermy-related bladder injury necessitating laparoscopic repair, and 3/22 (13.6%) slipped sutures, requiring repeat first-stage procedures. Conclusions: Staged laparoscopic traction orchidopexy is a feasible technique, which can be performed as an alternative to Fowler–Stephens procedure, with potentially better outcomes for the testis. The complications described should be preventable as the technique evolves.

Dr. Richard Gill published a textbook in London in 1906 titled The CHCl3– Problem. Gill was the Chief Chloroformist at St Bartholomew’s Hospital, London, and was recognized as an excellent clinical anesthetist and was of an intelligent but reclusive and eccentric personality. This textbook is rarely found and has not been appreciated in the history of anesthesia for several reasons including that it was generally ignored at publication and few copies exist in libraries around the world. The CHCl3Problemis written in a verbose, archaic, and convoluted fashion and is rarely quoted. It has no references whatsoever.

Meeting ProgrammeProf David O'Hagan [University of St Andrews, UK]—Enzymatic C–18F Bond Synthesis: A New Strategy for PET Synthesis.Dr Michael Carroll [University of Newcastle, UK]—Studies Towards 6‐[18F]Fluoro‐m‐tyramine using Iodonium Salts.Dr John Gardiner [University of Manchester, UK]—Methods Towards Isotopomer‐Versatile Synthesis of 13C‐Labelled Carbohydrates.Prof William Lockley [University of Surrey, UK]—Some New Catalytic Systems for Isotope‐Exchange Labelling.Dr David Rustidge [Scynexis Europe, UK]—14C‐Synthesis—Not Always as Easy as it Looks.Dr Richard Hartley [University of Glasgow, UK]—The Potential for using Titanium Alkylidene Chemistry in Solid‐Phase Radiochemical Synthesis.Dr Ian Wilson [Turku Imanet, Finland]—Transition of PET Tracers from Clinical Research Tools to Commercial Diagnostics.Dr Simon Harwood [GlaxoSmithKline, UK]—The Synthesis of Stable Labelled Ketamine.Dr John Herbert [Sanofi‐Aventis, UK]—Towards Robust Conditions for Iridium‐mediated Exchange.Dr Conor Barry [University of Bristol, UK]—Total Synthesis of Clavosolide A.

Introduction Infantile hypertrophic pyloric stenosis (IHPS) is a common surgical condition, but there are no guidelines regarding preoperative fluid resuscitation. Our aim was to evaluate a novel consensus care pathway for IHPS, incorporating a standardized fluid and electrolyte replacement regime.Methods One hundred patients were initially reviewed and compared to thirty-three patients following the introduction of a clinical pathway, whereby infants requiring electrolyte correction received 150 ml/kg/24 h of 0.45% saline, 5% dextrose and 10 mmol KCl, with systematic blood sampling until correction was achieved. We measured time to electrolyte correction, time to surgery and total length of hospitalization. Data were described using the median and interquartile range, and differences between the groups’ categorical and continuous data were described using Chi-squared and the Mann–Whitney U–tests, respectively.Results Time in hours taken to correct electrolytes was reduced: 25(16.5–42) versus 9.5(4.5–24.75) p= 0.004. Time to surgery from admission in uncorrected patients decreased from 50(40.25–66.75) to 39(28.75–41.75) p= 0.018. Subsequently, there was a reduction in total length of stay: 94(71–93.5) versus 75(64.5–93.5) p= 0.025. Parental satisfaction increased from 77% in the pre-pathway group to 83% in the pathway group.Conclusion A consensus care pathway for IHPS reduces the time taken to correct preoperative electrolyte abnormalities, decreases length of hospitalization and improves parental satisfaction.

The administration of chloroform by John Snow to Queen Victoria to provide analgesia for the delivery of her children was a pivotal moment in the development of anaesthesia. It has long been thought that this was the only occasion she had experienced anaesthesia but examination of her diaries shows this to be untrue.

The recently published procedure for the metallation of heteroaromatics and their subsequent reaction with iodine has been applied to the synthesis of deuteriumlabelled compounds. The mixed magnesiumlithium base 2 has been prepared and reacted with a range of heteroaromatics. The metallated compounds were iodolyzed with molecular iodine and the resulting iodo compounds were reductively dehalogenated with deuterium gas. This allowed confirmation of the regiochemistry of the metallation and the use of the procedure as a labelling method. Copyright © 2009 John Wiley & Sons, Ltd.

A solid‐phase, iridium‐based ortho‐exchange catalyst has been developed, with the aim of producing cleaner, more efficient, systems for tritium and deuterium labelling. The catalyst, which is a solvated polystyrene‐bound triphenylphosphine complex of cyclooctadienyliridium(I) hexafluorophosphate, was evaluated with respect to more conventional catalysts such as CODIr(PPh3)2PF6 and the Crabtree catalyst using simple model compounds as substrates. Labelling of drug candidate molecules proceeds with high regioselectivity and, after a simple filtration step, affords products with high radiochemical purities directly from the exchange reaction. The solid‐phase catalyst functioned well with a variety of traditional directing groups including nitro, amide, benzophenone and N‐heterocycles. Copyright © 2007 John Wiley & Sons, Ltd.

A sensitive radioimmunoassay method for sodium cromoglycate in human plasma is described. The lowest quantifiable concentration of sodium cromoglycate is 0·93 nmol/l when 0·1 ml plasma samples are analysed. Direct analysis of sodium cromoglycate concentrations in plasma samples collected up to several hours after the administration of single therapeutic doses of the compound is possible. An antiserum raised in a sheep, radioligand heterogeneously labelled with iodine-125, and a second antibody technique for the separation of bound and free radioligand are employed. The inter-assay coefficient of variation is less than 14% (n=23). The range of the method is limited; both 0·01 and 0·1 ml volumes of plasma must be analysed to encompass the concentration range 0·93–139 nmol/l which may be encountered in plasma samples from patients and human volunteers. The method is specific for sodium cromoglycate as indicated by a low cross-reactivity of the anti-cromoglycate antiserum with a number of drugs.

Day-case surgery is rapidly expanding throughout the Western world. This expansion is primarily the result of financial pressure from health care administrators, and many surgeons and anaesthetists have been reluctant to become involved in this type of practice. A series of helpful reports have appeared in the UK which give pointers to those trying to improve their throughput of such work, both for adult and paediatric day-care. Much research is currently underway in this field as anaesthetists try to decrease the morbidity of increasingly complex surgery for day-care. Interesting avenues are in geriatric care, preoperative and outcome assessment, recovery from anaesthesia and perioperative fluid therapy. Propofol is proving to be the drug of choice for the majority of day anaesthesia, but some adverse phenomena have been reported and more time will be needed to fully evaluate its place. More extensive audit of day-care work is urgently needed to provide information for future treatment plans. Nausea and vomiting remain as some of the worst after effects of anaesthesia. Despite a wide variety of anti-emetic drugs these symptoms are poorly controlled. Acupuncture and acupressure are proving to be interesting lines of research while other investigators continue to introduce newer drugs such as alizapride and dixyrazine. Other possible research areas include the use of traditional herbal remedies such as ginger root. Work on the history of anaesthesia continues to appear in a few of the mainstream anaesthetic journals. The majority of this work is on the historical use of specific drugs like muscle relaxants, the evolution of specific items of apparatus, or the life histories of noteable pioneers. Anaesthetic historians need to develop greater appreciation of the wider social, political and economic forces that were moulding the lives and researches of their topics. Editors of journals should be encouraged to publish more historical work.

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