Dr Adrian R Lloyd-Thomas  Consultant Paediatric Anaesthetist

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CURRICULUM VITAE

OF

Dr. A. R. LLOYD-THOMAS

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School

1967 to 1972, Westminster School, Dean's Yard, London SW 1.

Member of the school fencing team from 1969 to 1972.

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Sabbatical Year

In this year I worked for eight months to earn sufficient funds to enable me to travel overland to Nepal. I was able to do this in the last four months of the year.

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Medical Training

Pre-clinical and clinical studies at the London Hospital Medical College from 1973 to 1978.

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Qualifications

MB BS  (University of London), 1978.

FFARCS  (England) 1984.

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Accreditation

My certificate of accreditation was awarded by the joint committee in May 1987.

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Prizes

Westminster School Science Exhibition, 1971

Keith Thomas Memorial Prize for Paediatric Anaesthesia, 1985.

Fellow of the Belgian Society of Anaesthesiologists, by election 2001. In recognition of services to the relief of pain in children.

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Membership of Societies

The Association of Anaesthetists

Fellow of the Royal Society of Medicine

Member of The Association of Paediatric Anaesthetists

Member of The Anaesthetic Research Society

Member of The Association of Cardiothoracic Anaesthetists

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Present Appointments

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Consultant Paediatric Anaesthetist in Independent Practice (admitting rights at the Portland Hospital and the Harley Street Clinic) Independent practice commenced 1989, since 2014 in full independent practice. 

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Deputy Chair of the Portland Medical Advisory Committee. (2015-)

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Consultant Paediatric Anaesthetist, Great Ormond Street Hospital for Children NHS Trust, London. (Commenced 01.01.1988- Retired 30.06.2014)

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Senior Lecturer in Paediatric Anaesthesia, The Institute of Child Health, Guilford Street, London (University of London) (Commenced 01.01.1988- Retired 30.06.2014).

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Previous Trust Appointments

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College Tutor for Anaesthesia, Great Ormond Street Hospital for Children NHS Trust, London. (1989-1995)

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Deputy Clinical Director, Anaesthesia and Theatres        1997-2000

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Clinical Director, Anaesthesia and Theatres            2000-2002

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Clinical Director, Division of Anaesthesia and Surgery        2002-2005

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Committees

Trust:

Chairman        Electronic Prescribing Committee        2002-2005

Chairman        Drug and Therapeutics Committee    1998-2003

Chairman        The Antimicrobial Working Party        2000-2003

Member        Electronic Patient Record Committee    1999-2004

Chairman        Pharmacy Information Project Board    1998-1999

Vice-Chairman    Drug and Therapeutics Committee    1997-1998

Chairman        Pharmacy Information Working Party    1996-1998

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Anaesthesia Representative on the Postgraduate Medical Education Committee, (1995-1998)

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Institute of Child Health

Member of the Search Committee, The Portex Chair of Paediatric Anaesthesia, (2000-2001).

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Regional:

Member The Camden and Islington Prescribing Committee, (1998-2003)

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Member The Camden and Islington Working Party on Secondary Surgical Services, (2000-2001).

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North East Thames Advisory Committee on Higher Professional Training, (1989 - 1995) 

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Member North East Thames Advisory Committee on General Professional Training, (1989-1995)

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National:

Member ,Working Party on the Control of Pain in Children, Royal College of Paediatrics and Child Health, representing the Royal College of Anaesthetists. (1997-1998)

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Member, Commission of Enquiry, Circumcision in Children, Royal College of Paediatics and Child Health, representing the Royal College of Anaesthetists. (1997-1999)

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Advisory Committiees:

I represent the College on Advisory Committees for Consultant Appointments.

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Appointments Held

August 1978 to January 1979     House Surgeon

The Department of Surgery, St. John's Hospital, Chelmsford, Essex.

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February 1979 to July 1979     House Physician

The Department of Medicine, The Ipswich Hospital, Heath Road,

Ipswich, Suffolk

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August 1979 to January 1980    Senior House Officer

Accident and Emergency, The Middlesex Hospital, Mortimer Street, London W1.

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February 1980 to January 1981    Senior House Officer

The Department of Medicine, Southend Hospital and Rochford Hospital, Southend on Sea, Essex.

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February 1981 to July 1981    Senior House Officer

The Intensive Care Unit, Charing Cross Hospital, London, SW 6.

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August 1981 to July 1982    Senior House Officer

The Department of Anaesthesia, The London Hospital, Whitechapel, London E 1.

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August 1982 to May 1984    Registrar

The Department of Anaesthesia, St. Bartholomew's Hospital, London EC 1.

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May 1984 to May 1985    Registrar

The Department of Paediatric Anaesthesia, Alder Hey Children's Hospital and The Royal Liverpool Children's Hospital, Liverpool.

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May 1985 to December 1987    Senior Registrar

Department of Anaesthesia, St. Bartholomew's Hospital, London EC 1.

Rotating to:

Department of Anaesthesia, Hackney Hospital, London E 7.

Department of Anaesthesia, Whipps Cross Hospital, London E 11.

The Medical College of St. Bartholomew's Hospital, Charterhouse Square, London EC 1 (Lecturer in Anaesthesia)

The Department of Anaesthesia, Hospitals for Sick Children, Great Ormond Street, London WC1N 3JH.

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EXPERIENCE

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GENERAL AND HIGHER PROFESSIONAL TRAINING

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General medicine

I was fortunate to spend a year training in acute general medicine before starting my subsequent training in anaesthesia and intensive care. As both hospitals had busy coronary care units I gained particular experience in the diagnosis and management of ischaemic heart disease.

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Anaesthesia

During my general and higher professional training, I gained wide experience of regional and general anaesthesia in all fields of  surgery for both adults and children.

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Specialist training in anaesthesia

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Paediatric Cardiac Surgery

I was trained at both the Royal Liverpool Childrens' Hospital and Great Ormond Street in the conduct of anaesthesia for  thoracic, open and closed heart surgery. 

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Adult Cardiac Surgery

I was trained in adult cardiac surgery at the London Hospital and St. Bartholomew's Hospital. This included experience in the conduct of anaesthesia for coronary vein grafts, valve replacement, arrythmia surgery including implant defibrillators, aortic root replacement, and coarctation repair. 

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Intensive Care Medicine

I have been fortunate to have received training in intensive care medicine for both adults and children at Charing Cross (with Prof K Hillman), at St Bartholomew's Hospital (with Dr C J Hinds), at Whipps Cross Hospital (with Dr Gillian Hanson) at The Royal Liverpool Children's Hospital (with Dr E Vivori and Dr G H Bush) and at Great Ormond Street. I have gained a wide experience in the management of acutely ill patients, including parenteral nutrition, peritoneal dialysis, haemofiltration and haemodialysis, techniques of invasive cardiovascular monitoring, mechanical ventilation, intracranial pressure monitoring and neurophysiological assessment by cerebral function monitor, EEG and evoked potentials.

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CONSULTANT EXPERIENCE

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My appointment to the Hospital for Sick Children was to service the increased work of the cardiothoracic unit associated with the opening of the new cardiac wing. My sessions were mixed with 70% of my time devoted to the cardiac unit (theatre, catheter lab and intensive care unit), whilst the remainder was other paediatric surgery. I was appointed Consultant in charge of anaesthetic services for the cardiac catheter laboratory. 

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This mix of sessions provided useful opportunities to consolidate my training and become fully familiar with all aspects of paediatric anaesthesia. Expertise in anaesthetic and intensive care management of other fields of paediatric surgery is invaluable in improving the quality of care given to children with congenital heart disease who so often have multisystem abnormalities. 

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After 2 years I dropped my general surgical sessions apart from one ENT list, and maintained my commitment to the cardiothoracic unit. My on call commitment moved from Queen Elizabeth's Hospital to Great Ormond Street entailing full coverage of cardiac emergencies in children, including heart and heart and lung transplantation.

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I made this move when I established the Acute Pain Service and I provide consultant cover for this new service. I was able to establish the service by making a joint application with Dr Sumner (Chairman of the Division) to the Differential Allocation. This source of funding is based upon competitive bids, the successful applicants being chosen by a committee of the Department of Health.

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My time is now divided 40% to the cardiothoracic unit, 30% to ENT surgery and 30% to the Pain Service. This has enabled me to participate in and instigate research and development within the field of cardiothoracic anaesthesia and has allowed me to assist in the development of techniques such as extracorporeal membrane oxygenation, modified ultrafiltration after bypass,  and non-invasive measures of cerebral blood flow and cerebral oxygenation.

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My consultant career has developed to give me three main areas of expertise, namely cardiothoracic and ENT anaesthesia and acute pain control.

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Management Experience

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I have had experience of managing the introduction of a pharmacy IT system and developed an understanding of tendering, contract assessment, project management and the management of suppliers.

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I started as Clinical Director for Anaesthesia and Theatres and then participated in the merger of surgical specialites with anaesthesia to form the Directorate of Anaesthesia, Surgery and Theatres. I established with my Co-Clinical Director, a Management Board to run the Directorate. In this capacity have gained experience of budgets, waiting list management, service planning as well as general day to day business management.

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Upon re-organisation I became Clinical Director for the Division of Anaesthesia and Surgery, managing a budget of £28M, responsible for the delivery of over 12,000 operations per annum and managing 75 consultant colleagues. Responsibilities included the introduction of consultant appraisal and the new Consultant Contract.

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I have been a member of the Trust Management Board for 5 years.

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Cardiac anaesthesia abroad

I am privileged to have been appointed Consulting Paediatric Cardiac Anaesthetist to the Maltese Government, in which capacity I visit the island on an annual basis to provide anaesthetic services for children undergoing cardiac surgery (Mr M Elliott) and cardiac catheterisation (Dr K Hallidie-Smith). This visit offers an unrivalled opportunity for the teaching and training of the local Maltese anaesthetic staff.

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TEACHING AND TRAINING

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In addition to clinical teaching in theatre and in intensive care, I participate and give regular tutorials in the department's academic programme. I also teach external visitors to the Great Ormond Street Pain Service who attend for two-week attachments. I have enjoyed giving a programme of lectures in many countries.

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College Tutor

I was appointed by the College of Anaesthesia as tutor to the Hospital for Sick Children from 1989 to 1995. 

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Course Organiser

I am the Great Ormond Street organiser for the St.Thomas' Hospital Final FRCA course.

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College FRCA Course

I lecture on the Final FRCA course organised by the Royal College of Anaesthetists.

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Nurse Education

I regularly lecture to nursing staff on the ENB 415 Paediatric Intensive Care and Cardiac Intensive Care Course. I talk also to the Pain for Paediatric Nurses Course.

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SCIENTIFIC REFEREE

I am a referee for papers submitted to the following journals; American Journal of Medicine, Intensive Care Medicine, British Journal of Anaesthesia British Medical Journal and Lancet.

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EDITORIAL WORK

I was a member of the International Editorial Board for the Journal "Acute Pain” from 1998 to 2012.

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RESEARCH

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Grants awarded for research

I was awarded £7500 by the Joint Research Board of the Institute of Child Health to examine the neurophysiology of anaesthesia in children.

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I was awarded £50,000 for the study of Ketorolac in patients receiving PCA morphine following major surgery.

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I have been part of the founder group, organising the Children Nationwide Pain Research Centre.

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Midazolam Infusions

I investigated the use of midazolam for the sedation of children following cardiac surgery.

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Critical Illness in Oncology Patients

I have surveyed the outcome of patients with haematological malignancy who require intensive care.

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NEUROPHYSIOLOGY

I have established a fruitful relationship with the Department of Neurophysiology to develop a full programme to investigate the changes in evoked responses and encephalogram during anaesthesia and cardiopulmonary bypass.

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Neurophysiology during adult anaesthesia

I investigated the changes, which occur in the processed EEG (CFAM) and brain stem auditory evoked responses during halothane or isoflurane anaesthesia in adults. Using this database I examined the potential cerebral protective properties of isoflurane during induced hypotension.

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Neurophysiology during paediatric anaesthesia

I have investigated the changes in the processed EEG and somatosensory evoked responses during isoflurane anaesthesia in children. This work is now being extended to examine the changes, which occur in both evoked responses and the processed EEG during cardiopulmonary bypass.

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Neurophysiology of pain transmission

I am investigating somatosensory evoked responses to laser induced stimulation of skin nociceptors.

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CARDIOPULMONARY BYPASS RESEARCH

In collaboration with cardiac surgical colleagues, I have been able to establish two areas of research.

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Modified Ultrafiltration

The use of ultrafiltration after cardiopulmonary bypass has improved circulatory dynamics following open-heart surgery as well as allowing the use of crystalloid prime in small children. As part of the investigation we have examined the pharmacodynamics of nitroprusside, nitrates, dobutamine and fentanyl during bypass and post-bypass filtration.

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Cerebral blood flow

We are establishing a project to use the Niroscope to measure cerebral blood flow during cardiopulmonary bypass by non-invasive means. The Niroscope can also measure the oxidation-reduction potential of cytochrome 3a, thereby potentially providing a method to measure the adequacy of cerebral oxygenation during bypass. We have submitted a grant application to the British Heart Foundation.

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PAIN RESEARCH

A programme of pain research has been established as part of the pain service, this is facilitated by links established with the Departments of Anatomy and Neurobiology at University College London and the Department of Neurophysiology at GOS. Further links have been created with the pharmaceutical industry (Boots and Syntex) to commence therapeutic studies in children.

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PRESENTATIONS TO LEARNED SOCOETIES

Invited Lectures

"The Alder Hey technique of paediatric anaesthesia" to the Department of Anaesthesia St. Bartholomew's Hospital, December 1984

"The EEG in anaesthetic practice" to The Young Travellers Club, St Bartholomew's Hospital, May 1986.

"Hypotensive anaesthesia- what should we monitor?" to The Department of Anaesthesia, Whipps Cross Hospital, February 1987.

"Cerebral protection by isoflurane?" to The Southern Society of Anaesthetists, January 1988.

"Pain management in children" to The North East Thames Association of Anaesthetists, November 1989.

"The control of pain in children" to a Paediatric Nurses Study Day, English Nursing Board, December 1989.

"Evaluation of depth of anaesthesia- EEG and evoked potentials in adults and children" to Seminars at Nine Bedford Square, Association of Anaesthetists, March 1990.

"Pain management in children" to The Bristol Anaesthetic Group, April 1990.

"Pain management in children" to the Pain and Nocioception Group, Charing Cross Hospital, May 1990.

"Pain in children- an overview" to Seminars at Nine Bedford Square, February 1991.

"The Acute Pain Service for Children" to The Department of Anaesthesia, The Royal London Hospital, March 1991.

"Is pain inevitable after surgical operations in children?" to the National Association for the Welfare of Children in Hospital (Scotland), March 1991.

"Modern techniques of pain management for children" to the Pain and Nocioception Group, Charing Cross Hospital, May 1991.

"Pain control for children" to the Department of Anaesthesia Guy's Hospital, October 1991.

"Pain management for children".  to The University of Edinburgh, November 1991.

"Improving pain management in children" to the Department of Anaesthesia, The Royal Berkshire Hospital, December 1991.

"Pain relief in children".  Early morning seminars, The Portland Hospital, August 1992.  

"Regional anaesthesia in children" to the Pain and Nociception Group, St Thomas's Hospital, December 1992.

"Post-operative Pain Relief for Children" The North London FRCA Course Part III March 1993.

"Post-operative Pain relief for Children" to the Department of Anaesthesia Epsom Hospital, March 1994.

"Post-operative Pain Relief for Children" The North London FRCA Course Part III March 1994.

"Current Perspectives in Paediatric Pain Control" to The Nuffield Department of Anaesthesia, John Radcliffe Hospital, Oxford, October 1994.

"Practical Post-operative Pain Control for Children" to The Departments of Anaesthesia, Ascot and Wexham Park Hospitals, Ascot, November 1994.

"Post-operative Pain Relief for Children" The North London FRCA Course Part III March 1995.

"How to organise a children's Pain Service" to the Alder Hey Children's Hospital (Evening Postgraduate Lectures), June 1995. 

"Progress in Paediatric Analgesia" to the Department of Anaesthesia , Addenbrooke's Hospital, Cambridge, July 1995.

"Post-operative Pain Relief for Children" The North London FRCA Course Part III March 1996.

"Neurophysiology of Pain"  ENB Nursing course, London March 1996.

"Pharmacodynamics of Morphine in Children"  ENB Nursing course, London March 1996.

"Anaesthesia for Paediatric Otolaryngology" The Paediatric ENT Masterclass, London April 1996.

"Aspects of Paediatric Anaesthesia". The Royal College of Anaesthetists Final FRCA course, London April 1996.

"Paediatric Regional Anaesthesia" The Royal Sussex County Hospital, Department of Anaesthesia, July 1996.

"Paediatric Anaesthesia, The Heart of the Matter" Conference at the Royal College of Nursing, London October 1996

"Post-operative Pain Relief" St Thomas's Hospital Final FRCA course October 1996.

Recent advances in postoperative pain" The Paediatric Pain Group  Meeting "Pain in Children" London November 1996.

"The development of the immature fetal nervous system" CIBA Foundation meeting "Pain in the Fetus", London December 1996.

"Post-operative Pain Relief for Children" The North London FRCA Course Part III April 1997.

"Anaesthesia for Paediatric Otolaryngology" The Paediatric ENT Masterclass, London April 1997.

"Post-operative Pain Relief for Children" The North London FRCA Course Part III September 1997.

"Post-operative Pain Relief for Children" The Royal College of Anaesthetists Final FRCA Course October, 1997.

"Anaesthesia for Paediatric Otolaryngology" The Paediatric ENT Masterclass, London March 1998.

"Post-operative Pain Relief for Children" The Royal College of Anaesthetists Final FRCA Course October, 1998.

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Plenary Lectures

"Sedation of children requiring intensive care" to the 5th European Congress of Intensive Care Medicine, June 1990.

"Improving pain management for children" to the Winter Meeting of the Association of Anaesthetists, January 1991.

"Regional analgesia in children" to the European Congress of Pain Therapy, Paris May 1991.

"Pain relief in children" to the Continuing Medical Education Day, The Royal Society of Medicine, October 1992.

"Establishing an acute pain service for children" to international course on regional anaesthesia in children, Pisa, March 1993.

"Pain control in the intensive care unit" to The Third International Congress of Paediatric Intensive Care, Padua, July 1993.

"An acute pain service for children" to The Third European Congress of Paediatric Anaesthesia, Liverpool, September 1993. 

"The Laryngeal Mask Airway in Paediatric Otorhinolaryngology" to The ENT Section the Royal Society of Medicine, March 1994.

"Pain control for children- recent advances" to The Third European Congress of Anaesthesia, Brussels, February 1994.

"The Neurophysiology of Nociception" to The International Third Weekend of Paediatric Anaesthesia, Coimbra, Portugal May 1994.

"The Pharmacology of Options" The International Third Weekend of Paediatric Anaesthesia, Coimbra, Portugal May 1994.

"NSAID's for children's post-operative analgesia" The International Third Weekend of Paediatric Anaesthesia, Coimbra, Portugal May 1994.

"Advancing the Concept of a Paediatric Pain Control Team" The European Federation of Associations of Paediatric Anaesthesia, Florence, October 1994.

"Current problems in Paediatric Pain Control" to The Association of Anaesthetists (Seminars at 9 Bedford Square), London, October 1994

"Post-operative Pain Control for Children" to The Section of Anaesthesia, The Manchester Medical Society, Manchester, November 1994.

"Aspects of Paediatric Pain Control", The Association of Anaesthetists, Winter Meeting, London January 1995

"The Management of Pain in Children". To the First Congress of Paediatric Anaesthesia. The Romanian Society of Anaesthesia. Bucharest, Romania. October 1995.

"Paediatric Pain an Overview" to The Association of Anaesthetists (Seminars at 9 Bedford Square), London, October 1995.

"Acute Pain in Children. Have we advanced?" Pain in Children, the Centenary Meeting of the Royal Hospital for Sick Children Edinburgh, Edinburgh Scotland, November 1995.

"Post-operative Pain Control after Abdominal Surgery". The IIIrd European Course on Paediatric Anaesthesia. The European Society of Paediatric Anaesthesia, Brussels, November 1995.

"The Difficult Airway" The First International Update in Anaesthesia, Pain and Critical Care. The Indian Society of Anaesthesiology, Bombay, India. December 1995.

"The Neurophysiology of Pain". The First International Update in Anaesthesia, Pain and Critical Care. The Indian Society of Anaesthesiology, Bombay, India. December 1995.

"Post-operative Pain Management using opioids and minor analgesics" The First International Update in Anaesthesia, Pain and Critical Care. The Indian Society of Anaesthesiology, Bombay, India. December 1995.

"The Neurophysiology of the Developing Nociceptive System" The First International Congress of Anaesthesia of Maderia, Funchal, April 1996.

"Post-operative Pain Control in Children" The First International Congress of Anaesthesia of Madeira, Funchal, April 1996.

"What is the future of Paediatric Pain Relief?" The Portex International Symposium on Developments in Paediatric Anaesthesia, Sophia Children's Hospital, Rotterdam, June 1996.

"The Neurophysiology of Pain" The IIIrd World Congress of Paediatric Intensive Care, Rotterdam, June 1996.

"The Airway in ENT Anaesthesia" The IIIrd World Congress of Paediatric Intensive Care, Rotterdam, June 1996.

"Pre-emptive analgesia in paediatrics" The IVth European Congress of Paediatric Anaesthesia, Paris, May 1997.

"Regional anaesthesia in paediatric patients" The European Society of Regional Anaesthesia, London, September 1997.

‘Regional Anaesthesia in Paediatric Patients’ The Royal National Orthopaedic Hospital Update in Anaesthesia 2005.

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Papers read

Lloyd-Thomas AR Booker PD  sedation by midazolam infusions in paediatric patients following cardiopulmonary bypass, The Oxford Midazolam Seminar, March 1986.

Lloyd-Thomas AR Cole PV Prior PF Isoflurane prevents EEG depression associated with trimetaphan induced hypotension. The Anaesthetic Research Society, November 1986.

Lloyd-Thomas AR Booker PD Midazolam infusions in children. The London Midazolam Seminar, December 1986.

Lloyd-Thomas AR Cole PV Prior PF A comparison between EEG changes with isoflurane and with halothane during trimetaphan induced hypotension in man. International Symposium on Anaesthesia and Cerebral Function, Tubingen March 1987.

Lloyd-Thomas AR Wright I Hinds CJ. The prognosis of patients with life threatening complications of haematological malignancy who require intensive care. The Intensive Care Society, April 1987.

Lloyd-Thomas AR Isoflurane prevents EEG deterioration from induced hypotension during surgical operations. JAG Scientific Meeting, April 1987.

Lloyd-Thomas AR Cole PV Tooley MA Maynard DE Prior PF Reducing the risks of ischaemic brain damage from induced hypotension during surgical operations. Fourth European Congress of EEG and Clinical Neurophysiology, May 1987.

Mason DG Higgins D Lloyd-Thomas AR Boyd SG The effects of isoflurane anaesthesia on the median nerve somatosensory evoked potential in children, Anaesthetic Research Society, November 1990.

Mason DG Higgins D Lloyd-Thomas AR Boyd SG  The sequential measurement of the median nerve somatosensory evoked potential during isoflurane anaesthesia in children, Anaesthetic Research Society, November 1990.

Hodges U Berg S Naik S Lloyd-Thomas AR Elliott M, Filtration of fentanyl is not the cause of a rise in blood pressure following modified ultrafiltration in children, Cardiac Surgical Research Club, April 1991.

Fallon P, Kirkham FJ, Edwards AD, Lloyd-Thomas AR, Elliott M. Relationship between changes in cerebral blood volume and changes in arterial carbon dioxide tension investigated by near infrared spectroscopy during cardiopulmonary bypass in children. Neurological Society, January 1992.

Lloyd-Thomas AR.  Reflex sympathetic osteodystrophy in children.  The Association of Paediatric Anaesthetists, March 1992.  

Woodham MJ, Tyler D, Stocks J, Lloyd-Thomas AR.  Post-operative oxygen saturation in children receiving different analgesic techniques.  The Association of Paediatric Anaesthetists, March 1992.  

Wilson PTJ, Lloyd-Thomas AR.  Continuous extradural analgesia by infusion in children.  The Association of Paediatric Anaesthetists, March 1992. 

Lloyd-Thomas AR. "EMLA versus Amethocaine gel for topical anaesthesia". ESRA, September 1997.

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Poster Presentations

Lloyd-Thomas AR Hinds CJ Dhaliwal HJ Lister TA Intensive therapy for life threatening medical complications of haematological malignancy, Intensive Care Society, October 1983.

Lloyd-Thomas AR Wright I Hinds CJ Intensive therapy for life threatening medical complications of haematological malignancy: a five year experience. The 3rd European Congress of Intensive Care Medicine, June 1986.

Higgins D Forrest E Lloyd-Thomas AR  The Fenem CO2 detector as a method of confirming tracheal tube placement during the transport of critically ill children. The Scientific Meeting of The Association of Anaesthetists, October 1990.

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PUBLICATIONS

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Books 

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Pain and Stress in Infancy and Childhood. Eds Aynsley-Green A, Ward-Platt M. and Lloyd-Thomas AR., Balliere-Tindall, London 1995.

Hatch and Sumner’s Textbook of Paediatric Anaesthesia Eds. Bingham RM Lloyd-Thomas AR and Sury MRJ Hodder Arnold, London 2008.

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Book chapters

Lloyd-Thomas AR Anderson I Paediatric Trauma in The ABC of Major Trauma, Eds. Skinner, Driscoll and Earlam BMJ Publications 1991

Goldman A Lloyd-Thomas AR. Pain management in children. In Pain Mechanisms and Management, Eds. Wells JCD Woolf CJ. Churchill Livingstone, (British Medical Bulletin) 1991 

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Lloyd-Thomas AR.  "Establishing an acute pain service for children" in Regional Anaesthesia Techniques in Paediatric Patients.  Piccin, Padua; 1993.

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Lloyd-Thomas AR. "Acid-base balance". in Cardiopulmonary Bypass in Neonates, Infants and Young Children. Eds Jonas RA and Elliott MJ.  Butterworth-Heinemann, London 1994.

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Lloyd-Thomas AR. "Post-operative analgesia in Children", in Anaesthesia Review, Eds Kauffman L and Ginsberg R. House? London 1995.

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Lloyd-Thomas AR, Howard RF. Llewellyn N. "The management of acute and post-operative pain in infancy and childhood". In Pain and Stress in Infancy. Eds  Aynsley-Green A, Ward-Platt M and Lloyd-Thomas AR, Balliere Tindall, London 1995.

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Lloyd-Thomas AR Anderson I Paediatric Trauma in The ABC of Major Trauma (Second Edition), Eds. Skinner, Driscoll and Earlam. BMJ Publications 1996.

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Lloyd-Thomas AR. Perspective on Paediatric Pain Control. in Intensive Care in Childhood- a challenge to the future. Eds Tibboel D, van der Voort E. Springer Verlag, Berlin 1996.

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Chow G Roberts IG Fallon P Onoe M Lloyd-Thomas AR Elliott MJ Edwards AD Kirkham FJ. The relation between arterial oxygen tension and cerebral blood flow during cardiopulmonary bypass. Cerebral Protection in Cerebrovascular and Aortic Surgery. Eds Ennker J Coselli JS Treasure T. Springer Verlag Darmstadt 1997 pp 119-123.

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Scuplak S Lloyd-Thomas AR. Pain control and Sedation in Paediatric Intensive Care. Balliere's Clinical Paediatrics 1999:  

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Lloyd-Thomas AR. Anesthesia. In Practical Pediatric Otolaryngology. Eds. Cotton RT. Myer the III CM. Lippincott Raven, New York 1999.

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Lloyd-Thomas AR Anderson I Paediatric Trauma in The ABC of Major Trauma (Third Edition), Eds. Skinner, Driscoll and Earlam. BMJ Publications 2001.

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Lloyd-Thomas AR ‘Regional Anaesthesia in Children’, Textbook of Regional Anaesthesia Eds. Armitage and Wildsmith. Churchill Livingstone, 2002.

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Refereed Abstracts

Lloyd-Thomas AR Wright I Hinds CJ Intensive therapy for life threatening medical complications of haematological malignancy: a five year experience. Intensive Care Medicine 1986 12S 249

Booker PD Lloyd-Thomas AR Midazolam infusions in children. Abstracts of the 7th European Congress of Anaesthesiology. European Journal of Anaesthesia, 1986.

Lloyd-Thomas AR Cole PV Prior PF Isoflurane prevents EEG depression associated with trimetaphan induced hypotension. British Journal of Anaesthesia 1987 59 661P.

Lloyd-Thomas AR Cole PV Tooley MA Maynard DE Prior PF Reducing the risks of ischaemic brain damage from induced hypotension during surgical operations.Clinical Neurology and Neurosurgery 1987 89 30.

Mason DG Higgins D Lloyd-Thomas AR Boyd SG The effects of isoflurane anaesthesia on the median nerve somatosensory evoked potential in children. British Journal of Anaesthesia. 1991 66 399P 

Higgins D Mason DG Lloyd-Thomas AR Boyd SG  The sequential measurement of the median nerve somatosensory evoked potential during isoflurane anaesthesia in children. British Journal of Anaesthesia.1991 66 399-400P

Lloyd-Thomas AR.  Pain relief in children.  Abstracts of The Continuing Medical Education Day.  Association of Anaesthetists, London; 1992.

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Lloyd-Thomas AR.  "An acute pain service for children" in Abstracts of The Third European Congress of Paediatric Anaesthesia.  Association of Paediatric Anaesthetists, London; 1993.

Lloyd-Thomas AR.  "Non-steroidal anti-inflammatory drugs as analgesics for children".  Proceedings of the IIIrd Weekend of Paediatric Anaesthesia.  Coimbra, Portugal May 1994.

Lloyd-Thomas AR.  "Physiopathology of Pain".  Proceeding of the IIIrd Weekend of Paediatric Anaesthesia.  Coimbra, Portugal May 1994.

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Lloyd-Thomas AR.  "Pharmacology of opiates".  Proceedings of the IIIrd Weekend of Paediatric Anaesthesia.  Coimbra, Portugal May 1994.

Lloyd-Thomas AR "The Management of Pain in Children". Proceedings of the First Congress of Paediatric Anaesthesia. The Romanian Society of Anaesthesia. Bucharest, Romania. October 1995.

Lloyd-Thomas AR. "Acute Pain in Children. Have we advanced?" Proceedings of the Centenary Meeting of the Royal Hospital for Sick Children Edinburgh, Edinburgh Scotland, November 1995.

Lloyd-Thomas AR "Post-operative Pain Control after Abdominal Surgery". Proceedings of the IIIrd European Course on Paediatric Anaesthesia. The European Society of Paediatric Anaesthesia, Brussels, November 1995.

Lloyd-Thomas AR "The Difficult Airway" Proceedings of The First International Update in Anaesthesia, Pain and Critical Care. The Indian Society of Anaesthesiology, Bombay, India. December 1995.

Lloyd-Thomas AR."The Neurophysiology of Pain". Proceedings of The First International Update in Anaesthesia, Pain and Critical Care. The Indian Society of Anaesthesiology, Bombay, India. December 1995.

Lloyd-Thomas AR. "Post-operative Pain Management using opioids and minor analgesics" Proceedings of The First International Update in Anaesthesia, Pain and Critical Care. The Indian Society of Anaesthesiology, Bombay, India. December 1995.

Letters

Lloyd-Thomas AR Howard R. Post-operative pain control in children. British Medical Journal 1992: 304; 1174-1173.

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Knox-Kerr J, Lloyd-Thomas AR.  Selective endobronchial intubation in children.  Paediatric Anaestheisa 1993.

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Roberts I, Fallon P, Kirkham FJ, Lloyd-Thomas A, Cooper C, Maynard R, Elliott MJ, Edwards AD.  Estimation of cerebral blood flow with near infrared spectroscopy and indocyanine green.  Lancet 1993; 342: 1425.

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Papers

Lloyd-Thomas AR Bush GH All that wheezes is not asthma. Anaesthesia 1986 41 (2) 181-5

Lloyd-Thomas AR Dhaliwal HS Lister TA Hinds CJ. Intensive therapy for life threatening medical complications of haematological malignancy. Intensive Care Medicine 1986 12 (4) 317-24.

Booker PD Beechey A Lloyd-Thomas AR Sedation of children requiring artificial ventilation using an infusion of midazolam. British Journal of Anaesthesia 1986 58 (10) 1104-8.

Lloyd-Thomas AR Booker PD Infusion of midazolam in paediatric patients after cardiac surgery. British Journal of Anaesthesia 1986 58 (10) 1109-15.

Lloyd-Thomas AR Wright I Lister TA Hinds CJ. Prognosis of patients receiving intensive care for lifethreatening medical complications of haematological malignancy. British Medical Journal (Clin Res) 1988 296 (6628) 1025-9.

Black A Lloyd-Thomas AR An unusual case of stridor. Anaesthesia 1988 43(10) 870-1.

Lloyd-Thomas AR. Pain management in paediatric patients. British Journal of Anaesthesia 1990  64 (1) 85-104.

Lloyd-Thomas AR ABC of Major Trauma: Paediatric trauma: Primary survey and Resuscitation I. British Medical Journal 1990 301 (6747) 334-6.

Lloyd-Thomas AR ABC of Major Trauma: Paediatric trauma: Primary survey and Resuscitation II. British Medical Journal 1990 301 (6748) 380-2.

Lloyd-Thomas AR Anderson I  ABC of Major Trauma: Paediatric trauma Secondary survey British Medical Journal 1990 301 (6747) 334-6.

Lloyd-Thomas AR Cole PV Prior PF  Quantitative EEG and brain stem auditory evoked potentials: comparison of isoflurane with halothane using the cerebral function analysing monitor. British Journal of Anaesthesia  1990 65 (3) 306-12.

Lloyd-Thomas AR Cole PV Prior PF  Isoflurane prevents EEG depression during trimetaphan induced hypotension in man. British Journal of Anaesthesia 1990 65 (3) 313-18.

Murphy P Lloyd-Thomas AR Elliott M. The management of congenital tracheal stenosis in children. British Journal of Hospital Medicine 1990  44 (10) 266-270.

Murphy P Lloyd-Thomas AR The anaesthetic management of congenital tracheal stenosis in children. Anaesthesia 1991 46  106-109.

Mason DG Lloyd-Thomas AR Cyclopropane and the Datex Capnomac. Effect of cyclopropane on the single wavelength infrared measurement of volatile anaesthetic agents. Anaesthesia 1991 46 (5) 398-9.

Higgins D Forrest E Lloyd-Thomas AR  The Fenem CO2 detector as a method of confirming tracheal tube placement during the transport of critically ill children. Intensive Care Medicine, 1991.

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Goldman A, Lloyd-Thomas AR.  Pain management in children.  Br Med Bull 1991; 47: 676-689.

Mason DG, Higgins D, Lloyd-Thomas AR, Boyd SG.  The effects of isoflurane anaesthesia on the median nerve somatosensory evoked potential in children. British Journal of Anaesthesia 1992; 69: 562-566.

Mason DG, Higgins D, Boyd SG, Lloyd-Thomas AR.  The sequential measurement of the median nerve somatosensory evoked potential during isoflurane anaesthesia in children. British Journal of Anaesthesia1992; 69: 567-569.

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Hodges U, Lloyd-Thomas AR.  Anaesthestia for airway obstruction in laryngo-oncho-cutaneous syndrome.  Anaesthesia 1993; 48: 503-506.

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Lawson R, Lloyd-Thomas AR.  Three diagnostic connundrums solved by the laryngeal mask airway.  Anaesthesia 1993; 48: 790-791.

Wilson P, Lloyd-Thomas AR.  An audit of extradural infusion analgesia in children using bupivacaine and diamorphine.  Anaesthesia 1993; 48: 718-723.

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Lloyd-Thomas AR.  Postoperative pain control in children.  Current Paediatrics 1993; 3: 234-237.

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Lloyd-Thomas AR.  An acute pain service for children.  Anaesthesia Loco-Regionale 1993 2: 71-77.

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Fallon P, Roberts I, Kirkham FJ, Elliott MJ, Lloyd-Thomas A, Maynard R, Edwards.  Cerebral haemodynamics during cardiopulmonary bypass in children using near-infrared spectroscopy.  Ann Thorac Surg 1993; 56: 1473-1477.

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Fallon P, Roberts I, Edwards D, Elliott MJ, Lloyd-Thomas A, Kirkham F.  Measurement of cerebral blood flow in children undergoing open heart surgery with cardiopulmonary bypass by near-infrared spectroscopy.  Proc 2nd World Congress of Perinatal Medicine 1993; 1: 485-489.

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Lloyd-Thomas AR, Howard RF.  A pain service for children.  Paediatric Anaesthesia 1994; 4: 3-15.

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Fallon P, Roberts IG, Kirkham FJ, Edwards AD, Lloyd-Thomas A, Elliott MJ.  Cerebral blood volume responses to changes in carbon dioxide tension before and during cardiopulmonary bypass in children, investigated by near-infrared spectroscopy.  Eur J Cardiothorac Surg 1994; 8(3): 130-134.

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Lloyd-Thomas AR. Management of post-operative analgesia. Current Opinion in Anaesthesiology. 1994; 7: 262-6.

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Hodges U, Berg S, Naik S, Lloyd-Thomas AR, Elliott M.  Filtration of fentanyl is not the cause of a rise in blood pressure following modified ultrafiltration in children.  The Journal of Thoracic and Cardiovascular Anaesthesia 1994; 8: 653-7

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Hassan M, Lloyd-Thomas AR, Howard RF. Depthof epidural space in children. Anaesthesia 1994; 49: 1085-6.

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Tyler DC, Woodham M, Stocks J, Leary A, Lloyd-Thomas A

Oxygen saturation in children in the postoperative period. Anesth Analg. 1995 Jan 1; 80(1): 14-19. 

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Lloyd-Thomas AR Lauder G. Reflex Sympathetic Dystrophy in Children. British Medical Journal 1995: 310: 1648-9.

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de Lima J, Lloyd-Thomas AR, Howard RF, Sumner E, Quinn TM Infant and neonatal pain: anaesthetists' perceptions and prescribing patterns. BMJ. 1996 ; 313: 787.

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Lloyd-Thomas AR Fitzgerald M. Do fetuses feel pain? Reflex responses do not necessarily signify pain. British Medical Journal. 1996; 313: 797-798.

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Chow G, Roberts IG, Fallon P, Onoe M, Lloyd-Thomas A, Elliott MJ, Edwards AD, Kirkham FJ  The relation between arterial oxygen tension and cerebral blood flow during cardiopulmonary bypass. Eur J Cardiothorac Surg. 1997 Apr 1; 11(4): 633-639

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Chow G, Roberts IG, Edwards AD, Lloyd-Thomas A, Wade A, Elliott MJ, Kirkham FJ. The relation between pump flow rate and pulsatility on cerebral hemodynamics during pediatric cardiopulmonary bypass. J Thorac Cardiovasc Surg. 1997 Oct 1; 114(4): 568-577. 

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Lloyd-Thomas AR Paediatric pain- the next step? Paediatric Anaesthesia 1997 ;7: 487-493

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Lloyd-Thomas AR. Pre-emptive analgesia- relevant to children? Acute Pain 1998; 1: 20-26.

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Lloyd-Thomas AR.  Modern concept of paediatric analgesia. Pharmacology and Therapeutics 1999; 83: 1-20.

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Duce D Lloyd-Thomas A. Managing Pain in Babies. Anaesthesia and Intensive Care Medicine 2002; 1: 92-95.

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Afzal NA, Albert DA, Lloyd-Thomas A, Thomson M. A child with oesophageal strictures. Lancet 2002; 359; 1032.

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Sage FJ, Lloyd Thomas AR, Howard RF. Paediatric lumbar epidurals: a

comparison of 21-G and 23-G catheters in patients weighing less than 10 kg.

Paediatr Anaesth. 2000;10(3):279-82. PubMed PMID: 10792744.

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Smith OD, Callanan V, Lloyd-Thomas A, Albert DM. Pseudopolyp of the right

laryngeal ventricle following atraumatic intubation: a diagnostic dilemma.

Paediatr Anaesth. 2000;10(5):559-62. PubMed PMID: 11012963.

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White M, Shah N, Lindley K, Lloyd-Thomas A, Thomas M. Pain management in

fulminating ulcerative colitis. Paediatr Anaesth. 2006 Nov;16(11):1148-52. PubMed

PMID: 17040304.

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Tweedie DJ, Skilbeck CJ, Lloyd-Thomas AR, Albert DM. The nasopharyngeal prong 

airway: an effective post-operative adjunct after adenotonsillectomy for

obstructive sleep apnoea in children. Int J Pediatr Otorhinolaryngol. 2007

Apr;71(4):563-9. Epub 2007 Jan 22. PubMed PMID: 17241674.

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Skilbeck CJ, Tweedie DJ, Lloyd-Thomas AR, Albert DM. Suction diathermy for

adenoidectomy: complications and risk of recurrence. Int J Pediatr

Otorhinolaryngol. 2007 Jun;71(6):917-20. Epub 2007 Mar 30. PubMed PMID: 17399802.

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Ahmad N, Evans P, Lloyd-Thomas AR. Anesthesia in children with mastocytosis--a

case based review. Paediatr Anaesth. 2009 Feb;19(2):97-107. doi:

10.1111/j.1460-9592.2008.02904.x. Review. PubMed PMID: 19207896.

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Pratap JN, Sekhri C, Lloyd-Thomas AR. Anesthetic management for

adenotonsillectomy of a child with severe obesity due to homozygous

melanocortin-4 receptor gene mutations. Paediatr Anaesth. 2009 Feb;19(2):195-6.

doi: 10.1111/j.1460-9592.2008.02923.x. PubMed PMID: 19207921.

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Howard RF, Lloyd-Thomas A, Thomas M, Williams DG, Saul R, Bruce E, Peters J.

Nurse-controlled analgesia (NCA) following major surgery in 10,000 patients in a 

children's hospital. Paediatr Anaesth. 2010 Feb;20(2):126-34. doi:

10.1111/j.1460-9592.2009.03242.x. PubMed PMID: 20078810.

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Bajaj Y, Tweedie D, Ifeacho S, Hewitt R, Lloyd-Thomas A, Albert DM. Single

stage laryngotracheal reconstruction using endoscopic posterior grafting in

isolated posterior glottic stenosis in children - how we do it. Int J Pediatr

Otorhinolaryngol. 2011 May;75(5):624-6. doi: 10.1016/j.ijporl.2011.01.034. Epub

2011 Feb 27. PubMed PMID: 21362576.

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Tweedie DJ, Bajaj Y, Ifeacho SN, Lloyd-Thomas AR, Albert DM. Use of a

post-operative nasopharyngeal prong airway after adenotonsillectomy in children

with obstructive sleep apnoea: how we do it. Clin Otolaryngol. 2011

Dec;36(6):578-83. doi: 10.1111/j.1749-4486.2011.02392.x. PubMed PMID: 22212544.