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Clinical Applications of Diagnostic and Therapeutic Nerve Blocks. By Bonica John J.M.D., Published by Blackwell Scientific Publications, Oxford. Pp. 354; illustrated. Price 70s.
124
BRITISH JOURNAL OF ANAESTHESIA
Clinical Applications of Diagnostic and Therapeutic Nerve Blocks. By John J. Bonica, M.D. Published by Blackwell Scientific Publications, Oxford. Pp. 354; illustrated. Price 70s. Dr. Bonica is widely known as the author of the valuable work entitled The Management of Pain. This is a very different volume. It is, of course, much shorter and was written, according to the author's preface, to draw the attention of a wider field of clinicians to the scope of nerve blocking procedures. This book is not a manual of techniques, but rather a concise description of the basis for, and the uses of, nerve blocks. Nor is it an over-enthusiastic and uncritical plea for their widespread employment. The author has gone to considerable lengths to present an objective assessment of all the aspects. The first part, entitled "Basic Considerations", consists of seven chapters. These include a clear and concise discussion dealing with pain processes. It is followed by a section on "The Indications for Nerve Blocks" which to many English readers will seem interestingly broad in its coverage. The "Principles and Requisites for Optimal Results" is in many ways the most valuable chapter in the book and the advice concerning the approach to the patient, the choice of procedure and the appreciation of
limitations and disadvantages is excellent. Commenting on techniques, Bonica has again much good advice; not least the too seldom heeded reminder that measures for resuscitation and for the management of complications should always be at hand. The agents available to produce nerve blocks are briefly discussed. A number of these are as yet unavailable in the British Isles. The complications are very well dealt with in a short chapter. The second part of the volume, entitled "Clinical Considerations", is concerned with the uses of specific block techniques. Many anaesthetists, like the reviewer, will find themselves on unfamiliar territory, in particular when considering pains associated with myofascial syndromes and with bones and joints. The uses of autonomic blocks are fully treated and it is refreshing to note the author's clearly expressed opinions. He does not hesitate, for example, to report the failure of stellate ganglion block in the treatment of several disorders of the head and neck. The innumerable uses of somatic nerve blocks are considered at some length and there are chapters on subarachnoid and extra dural block. After reading this book one becomes aware that these procedures have much wider possibilities than is generally realized and perhaps should be much more widely employed. Despite Bonica's cautions it is easy to be carried away with enthusiasm, forgetting previous disappointments. Nevertheless this is a good book which is very well worth reading and which should attract many newcomers. The first section in particular commends itself to candidates for the Final F.F.A.R.C.S. examination. The text is adequately illustrated and it is not over-filled with references. There is a well selected bibliography at the back and a satisfactory index. It is well produced and printed and the reviewer noted only one spelling mistake. It is, however, rather expensive.
Primed in Great Brfufn by JOHW SHOUUTT & Sow. Ptrt Road. Altrinch»m
J. E. Riding
Downloaded from http://bja.oxfordjournals.org/ at Carleton University on May 8, 2015
equipped centres for dental treatment should be established and dental surgeons led by every inducement possible to think and plan along these lines. There are six appendices devoted to fainting, case reports, statistics and the questionnaires used during the author's investigations. This is a thought-provoking and characteristic book and, while some may quarrel at the conclusions reached and the solution proposed, the facts are impressive. The author's purpose will be served if they direct attention even more strongly to this field which has been so neglected. Cecil Gray
BRITISH JOURNAL OF ANAESTHESIA
Clinical Applications of Diagnostic and Therapeutic Nerve Blocks. By John J. Bonica, M.D. Published by Blackwell Scientific Publications, Oxford. Pp. 354; illustrated. Price 70s. Dr. Bonica is widely known as the author of the valuable work entitled The Management of Pain. This is a very different volume. It is, of course, much shorter and was written, according to the author's preface, to draw the attention of a wider field of clinicians to the scope of nerve blocking procedures. This book is not a manual of techniques, but rather a concise description of the basis for, and the uses of, nerve blocks. Nor is it an over-enthusiastic and uncritical plea for their widespread employment. The author has gone to considerable lengths to present an objective assessment of all the aspects. The first part, entitled "Basic Considerations", consists of seven chapters. These include a clear and concise discussion dealing with pain processes. It is followed by a section on "The Indications for Nerve Blocks" which to many English readers will seem interestingly broad in its coverage. The "Principles and Requisites for Optimal Results" is in many ways the most valuable chapter in the book and the advice concerning the approach to the patient, the choice of procedure and the appreciation of
limitations and disadvantages is excellent. Commenting on techniques, Bonica has again much good advice; not least the too seldom heeded reminder that measures for resuscitation and for the management of complications should always be at hand. The agents available to produce nerve blocks are briefly discussed. A number of these are as yet unavailable in the British Isles. The complications are very well dealt with in a short chapter. The second part of the volume, entitled "Clinical Considerations", is concerned with the uses of specific block techniques. Many anaesthetists, like the reviewer, will find themselves on unfamiliar territory, in particular when considering pains associated with myofascial syndromes and with bones and joints. The uses of autonomic blocks are fully treated and it is refreshing to note the author's clearly expressed opinions. He does not hesitate, for example, to report the failure of stellate ganglion block in the treatment of several disorders of the head and neck. The innumerable uses of somatic nerve blocks are considered at some length and there are chapters on subarachnoid and extra dural block. After reading this book one becomes aware that these procedures have much wider possibilities than is generally realized and perhaps should be much more widely employed. Despite Bonica's cautions it is easy to be carried away with enthusiasm, forgetting previous disappointments. Nevertheless this is a good book which is very well worth reading and which should attract many newcomers. The first section in particular commends itself to candidates for the Final F.F.A.R.C.S. examination. The text is adequately illustrated and it is not over-filled with references. There is a well selected bibliography at the back and a satisfactory index. It is well produced and printed and the reviewer noted only one spelling mistake. It is, however, rather expensive.
Primed in Great Brfufn by JOHW SHOUUTT & Sow. Ptrt Road. Altrinch»m
J. E. Riding
Downloaded from http://bja.oxfordjournals.org/ at Carleton University on May 8, 2015
equipped centres for dental treatment should be established and dental surgeons led by every inducement possible to think and plan along these lines. There are six appendices devoted to fainting, case reports, statistics and the questionnaires used during the author's investigations. This is a thought-provoking and characteristic book and, while some may quarrel at the conclusions reached and the solution proposed, the facts are impressive. The author's purpose will be served if they direct attention even more strongly to this field which has been so neglected. Cecil Gray