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The Modernisers

Imperial Chemical Industries (now AstaZeneca)drug


The insertion of a company is not what I would expect to place within this website, but ICI deserved to be mentioned because of this one development by them that has changed the face of day surgery.
Propofol along with the invention of the Laryngeal Mask Airway have been the two greatest anaesthetic developments in the last 30 years.

Patients, who at one time had operations that kept them in overnight because of the induction agents and post-operative airway management, now are released because of these two items the same day.                                                      

Propofol was discovered in the Biology Department at ICI Pharmaceuticals Division in the UK.
Over a ten year period more than 5000 compounds were tested as potential new anaesthetics.

The clinical trials followed in 1977, the drug was then solubilised in cremophor which produced anaphylactic reactions as it did with the drug it replaced Althesin. It was discovered that by emulsifying it in soya oil and water it was not reactive.

It was launched in 1986 under the brand name Diprivan. A new form of this drug will be launched shortly, a water soluble form (Fospropofol) that is less painful on injection and is said to be broken down even quicker. 218

Dr Archie Brain

By far the most impressive and useful modern day equipment contribution to anaesthetics is the invention is the Laryngeal Mask Airway. 

Archie Ian Jeremy Brain was born in Kobe, Japan to a British diplomat family. He won a scholarship to the University of Oxford and eventually decided to attend medical school, also at Oxford, with clinical training at St. Bartholomew's Hospital in London.

After obtaining a diploma in anaesthetics, he worked in Holland and the Seychelles, returning to the UK in 1980 to accept a post at the Royal London Hospital.

Brain worked on several research projects, one of the them being the prototype laryngeal mask airway, for which he received a patent in 1982. 271 It did not however become a common use item until Propofol became widely available, as it depressed the gag reflex better than thiopentone.

So the Laryngeal Mask Airway (LMA) was invented by Dr. Archie I.J. Brain in the East End of London in 1981. 
Dr. Brain identified the need for better safety, reliability, and the ease of insertion of airway management devices. 
He has gone on to modify this invention and produced different variations to deal with different anaesthetic conditions. 

They were at first, produced as multi-usable re-sterilisable items. They are now, however, developed as a single use and are disposable.




"It is a novel device that fills the gap in airway management between endotracheal intubation and in the use of facemask."

Archie Brain