Dr Donald D. Moir
1984-1987 - President
1988 - Gold medal winner
Donald Moir was born in Kendal of Scottish parents in 1929. When 4 years old he moved to Scotland, which has remained his homeland. He graduated MB ChB from Glasgow University in 1952 and proceeded MD in 1969 with a thesis on epidural analgesia. In 1961-2 he was a visiting fellow at Western Reserve University in Cleveland, Ohio, where Professor RA Hingson had developed a 24 hour resident service based on continuous caudal analgesia in labour and spinal anaesthesia for operative deliveries.
In 1963 Moir was appointed as the first consultant anaesthetist to the newly opened Queen Mother's Hospital, Glasgow and to the Western Infirmary. The new hospital provided a stimulating environment led by Ian Donald and a team of open-minded and progressive obstetricians. Within 6 months, probably the first British 24 hour resident service for obstetric anaesthesia and epidural analgesia had been started. Epidural techniques and indications had to be adapted to British practice. American practice was then based on operative deliveries for all and caudal analgesia was replaced by lumbar epidurals.
In 1970 Moir published a technique of general anaesthesia for Caesarean section based on 0.5% halothane with 50:50 nitrous oxide and oxygen and a muscle relaxant. This offered improved maternal safety, a low incidence of awareness, minimal neonatal depression, and showed that 0.5% halothane did not promote haemorrhage. In 1970 general anaesthesia was the rule for sections and the technique was used extensively for the next 20 years.
Moir and Moodie demonstrated that i.v. ergometrine often causes vomiting and hypertension and advocated its replacement by i.v. oxytocin, especially in conscious patients. Blood loss estimations in the late 1960s showed that epidural analgesia was associated with much reduced bleeding at forceps delivery in comparison with general anaesthesia and even pudendal nerve block.
Studies on epidural analgesia in the 1970s and 1980s helped prepare the way for the use of low concentrations of local anaesthetics and epidural opioids in labour and improved techniques for Caesarean section.
Moir was a member of the Scottish and English confidential enquiries into maternal deaths. These reports contributed substantially to the decline in maternal deaths under general anaesthesia and to the large reduction in the use of general anaesthesia in obstetrics.
Perhaps Moir's most important contribution was as a writer and teacher. He lectured widely at home and abroad and was a visiting professor in several centres in the USA, Canada, S Africa, Australia and New Zealand. In addition to some 50 papers, review articles and chapters he published Obstetric Anaesthesia and Analgesia which ran to three editions between 1976 and 1986, and Pain Relief in Labour: A Handbook for Midwives (5 editions between 1971 and 1986). These texts were widely read by anaesthetists and midwives.
Donald Moir retired in 1988 having been awarded the OAA Gold Medal for national and international services to obstetric anaesthesia. In retirement in rural Perthshire he obtained a BA (Hons) in history, art history and literature from the Open University, and passed his time hill walking, playing golf and working in his acre of garden while enjoying the company of his wife, children, grandchildren and friends. DDM
