The Nuffield Department of Anaesthetics (NDA), now renamed the Nuffield Division of Anaesthetics, was established in 1937 as the first academic department for British anaesthesia; arguably it was the first in the world, when Dr (later Sir) Robert Macintosh was elected to the Chair of Anaesthetics. Macintosh had great energy and was able to attract excellent colleagues who helped to expand the scope and technology of anaesthesia, including teaching and training, but at the same time ensured that Oxford became the citadel of progressive but safe, simple and straightforward anaesthetic practice.

The development of the Respiratory Unit, for example, was a great success and heralded present day Intensive Care Units. Macintosh was followed by Alex Crampton Smith, Keith Sykes, Pierre Foëx, Clive Hahn, Henry McQuay and Irene Tracey. The NDA played an important role in the development of prolonged artificial ventilation for neurological diseases such as polio, Guillain-Barré syndrome, tetanus (including the introduction of sympathetic blockade, a revolution in the treatment of this condition) and myasthenia gravis.

Major advances were made in the treatment of chronic pain, with one of the earliest tertiary pain relief units being established. Expertise in meta-analyses and systematic reviews led toevidence-based treatments of chronic and acute pain. Clinical and experimental applied cardiovascular and respiratory physiology studies were instrumental in developing the knowledge of the effects of anaesthetic agents and their interactions with cardiovascular drugs on the circulation, including the pulmonary circulation. Mathematical modelling of the lungs and gas exchange, based on experimental studies, forced a reappraisal of conventional concepts of ventilation.

Currently, the NDA operates as closely associated University and Hospital divisions and provides the framework for teaching, research and anaesthetic services. Going forwards the NDA is rightly positioning itself within clinical neurosciences and expanding its research aims, as a result of this exciting opportunity, by maintaining and developing internationally competitive research programs in the following core areas of anaesthetics:

• pain and consciousness;
  
• respiration and hypoxia;
  
• intensive care;
  
• simulation and human factors training.
  

Additionally we have nationally and internationally recognised teaching programmes in a range of anaesthetic related areas (e.g. primary trauma care, regional anaesthesia, anaesthesia in the developing world).