Thoracic Anaesthesia

Thoracic Anaesthesia

British Journal of Anaesthesia 108 (4): 707–8 (2012) BOOK REVIEWS Oxford Handbook of Anaesthesia, 3rd Edn. K. Allman and I. Wilson (editors). Publish...

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British Journal of Anaesthesia 108 (4): 707–8 (2012)

BOOK REVIEWS Oxford Handbook of Anaesthesia, 3rd Edn. K. Allman and I. Wilson (editors). Published by Oxford University Press, Oxford, UK. Pp. 1344; indexed; illustrated. Price £34.99. ISBN 978-0-19-958404-8.

D. J. Buggy Dublin, Ireland E-mail: [email protected] doi:10.1093/bja/aes076

Thoracic Anaesthesia. J. WilkinsonS. H. Pennefather and R. A. McCahon (editors). Published by Oxford University Press, Oxford, UK. Pp. 786; indexed: illustrated. Price £44.99. ISBN 978-0-19-956309-8. Thoracic Anaesthesia is the first edition from the series, Oxford Specialist Handbooks. It is written by 38 authors and complied by three editors. The book begins with the basic sciences, covering physiology, anatomy, and pharmacology.

& The Author [2012]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: [email protected]

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The primary objective of the third edition of this popular pocketbook, as stated in the authors’ preface, remains that it is a practical guide to the practice of anaesthesia for those who have mastered the basic principles. The chapters are written predominantly by UK clinician anaesthetists who are experts in their field, and the target readership is clinician anaesthetists facing practical clinical problems. The book is structured around subsections starting with preoperative assessment, followed by anaesthetic considerations in the various surgical specialities, including detailed chapters on obstetric and paediatric anaesthesia. It concludes with sections on anaesthetic emergencies, ‘practical anaesthesia’, and regional anaesthesia. The presentation is generally ‘easy on the eye’ with almost all text delivered in a bullet-point format, with liberal use of gentle, lilac-shaded tables. This is shown to advantage, for example, in the tabular presentation of the NICE guidelines on preoperative anaesthetic testing and the comprehensive listing of anaesthetic risk. An unusual feature of the chapter structure is that different subsections of single chapters are sometimes written by different authors, whose names are highlighted in the chapter summary pages to a greater extent than the title of the information being imparted, which I found somewhat disconcerting. Nonetheless, the editors have competently welded potentially contrasting styles of individual writers within these single chapters, to give a seamless, consistent readability throughout. The book has interesting, quirky headings of information on challenging practice, which I found particularly useful. Examples include Paul Myles’ single-page list of evidencebased medicine interventions in anaesthesia which ought to be deployed more widely or abandoned altogether, and the comprehensive summaries of anaesthetic considerations in ‘Uncommon Conditions’, including exotic diseases such as nesidioblastosis, cherubism, and Smith –Lemli –Optiz syndrome! These rarities, should one have the misfortune to come across them at short notice, are summarized in a single sentence with the main anaesthetic hazards outlined. Anaesthesia for particular surgical specialities follows in the same lucid style, preceded at the top of each page by useful tables, indicating likely duration, postoperative pain levels, and possible anaesthetic technique options for specific operations. The chapter on ‘The sick laparotomy’ is particularly meritorious, with useful links to chapters on sepsis syndrome and intensive care management. The obstetric anaesthesia section includes useful pages summarizing the poorly functioning epidural and

remifentanil in labour analgesia and, especially, breast feeding and drug transfer, and provide clinical advice for situations about which information can be difficult to access from other sources. Similarly, the section on paediatric and neonatal anaesthesia adds general points of importance, followed by a comprehensive list of management guidelines for specific paediatric surgeries. The chapter on critical care incorporates much on trauma resuscitation also, applying the primary survey to critical care in an interesting and logical way. Intensivists may be disappointed at the somewhat more limited range and depth of subject coverage here, but this textbook would hardly be designed to prioritize this complex subspeciality, which could be the focus of an entirely distinct manual in a similar format. The chapter on Emergencies is excellent with key relevant points of diagnosis and management presented together in a page or two. The Practical Anaesthesia section incorporates a number of topical issues around point-of-care monitoring such as oesophageal Doppler, depth of anaesthesia monitoring, cardiopulmonary exercise testing, and the recently reemerging thromboelastography. I was apprehensive that a detailed section of regional anaesthesia with its emphasis on ultrasound-guided techniques would not work in the context of this textbook. On the contrary, the result is a concise summary of relevant clinical knowledge on the conduct of regional techniques, complete with excellent schematic anatomical diagrams, and even the ultrasound images are generally unambiguous and worthy of inclusion. In summary, therefore, this pocket-portable textbook for practising clinicians is surprisingly comprehensive, has distilled much relevant detail and prioritized essential points, into its compact size. Overall, it provides an excellent compilation of relevant, readable, and insightful information and advice, for both the trainee and experienced consultant.

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A. Ng Wolverhampton, UK E-mail: [email protected] doi:10.1093/bja/aes077

Atlas of Common Pain Syndromes, 3rd Edn. S. D. Waldman (editor). Published by Elsevier Health, Philadelphia, USA. Pp. 408; indexed; illustrated. Price £ 76.99. ISBN 978-14377-3792-9. The majority of patients in the Pain Clinic have one of a relatively small number of diagnoses. Around 50% of patients in our clinic have spine pain and so we have become fairly adept at the diagnosis of spinal pain. However, there are many conditions that we see only very occasionally, not least because they fall under the remit of other specialities, but they may find their way to the Pain Clinic and so we need to be familiar with them, for example, cluster headache, plantar fasciitis, or manubriosternal syndrome. Making the correct diagnosis is the first step and making the correct diagnosis is the principle behind Steven Waldman’s Atlas. He describes more than 120 painful conditions, the majority of which are disorders of the musculoskeletal system and which vary in complexity from bursitis or tendonitis to radiculopathy, discitis, or phantom pain. This book is one from a series of Atlases in which the entire content of the book is available online under ‘expertconsult.com’ once the hardback is purchased. Each condition is placed into one of 16 sections depending on the anatomical location. Each condition is dealt with in a short chapter, two to three pages, which can be read in less than 15 min, making it a useful practical reference text. The chapters are clear and well presented, with each arranged in sections of signs and symptoms, tests, differential diagnosis, and treatment. There are numerous diagrams, X-ray, and CT images. There are few references, but this is not a book for in-depth study, there are plenty of those already available. Rather, it is an atlas to have in the clinic for frequent and quick reference. I expect this book will be popular to all medical and nonmedical pain specialists. It has gone down well in my clinic and I think represents a good investment. R. Atcheson Sheffield, UK E-mail: [email protected] doi:10.1093/bja/aes075

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These topics are followed by chapters on the conduct of anaesthesia for a variety of operations and cover preoperative assessment, minor procedures, and surgery to the lung, airway, chest, pleura, upper gastrointestinal tract, and mediastinum. The latter part of the book covers management of thoracic trauma, perioperative complications, critical care, and specific anaesthetic techniques. In addition to particular issues related to thoracic anaesthesia, the book contains a considerable quantity of general medical information. The book is easy to read, since it contains clear headings, subheadings, and bullet points. Clear classification provides a framework for assimilation of a broad spectrum of information. There are, in addition, a number of acronyms and other abbreviations which assist learning. Key points are emphasized throughout the book. Between topics, there are blank spaces for readers to make notes. Despite the multiple authorship, there is excellent uniformity in the various chapters. The text has clarity, breadth and depth, and should appeal to a broad spectrum of anaesthetists. For the junior doctor, the book is likely to provide essential knowledge for a day in the thoracic theatre. For example, the section on decortication covers pathophysiology, risk factors, clinical features, and principles of perioperative management. Each part could be read in 15 minutes whilst having a coffee break. This book may well be useful for examination candidates as it provides a framework for answering short essay questions. The book may appeal also to senior anaesthetists because it covers a broad number of topics including areas which they may encounter occasionally, for instance, lung transplantation, diaphramatic rupture, and penetrating trauma. In addition, the book will be of use for case-based discussions or viva voce practice with junior colleagues. I did find a few minor limitations in relation to content and presentation. For instance, one problem with a pocket-sized book is that figures, tables, and continuous prose are kept to a minimum, by necessity. Figures and in-depth discussion facilitate deeper understanding and so some readers may still prefer a larger textbook. The UK guidelines for lung cancer surgery were updated in 2010, and unfortunately, they were not included in this book. I was surprised to see that the section on analgesia did not feature intrathecal morphine which is effective for post-thoracotomy pain. Finally, the presentation could have benefited from a colour scheme other than only black and orange. In conclusion, Thoracic Anaesthesia is a well-presented, pocket-sized book. It should be of interest and use to a wide range of anaesthetists. I would like to congratulate the authors and editors on this book.

Book Reviews