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Advances in pain research and therapy, volume 14: opioid analgesia
190
BOOK REVIEWS
performed from an external or internal approach. The internal method is briefly explained, but deserves a diagram to fully convey the means of performing this black. The external approach is ignored but certainly worthy of presentation. The amount and concentration of lidocaine recommended for transtracheal blockade are excessive. The text’s real strength emerges in two chapters devoted to the actual use of fiberscopes. Descriptions of flexible fiberoptic intubations in both sedated and anesthetized patients are excellent. Consideration is given to nasal and oral approaches in both instances. The discussion of frequent causes of flexible fiberoptic intubation failures should be helpful to novice endoscopists. The presentation of double-lumen tube placement and positioning confirmation by endoscopy is well written. Suggestions for endotracheal tube changes using fiberscopes are also valuable. Diagrams are clear and add to appreciation of the text. Most photographs are of excellent quality, but some are difficult to interpret and, consequently, fail to aid the reader. If not for the price, this work would be a reasonable purchase for practitioners of anesthesia and critical care medicine. As it stands. Fiberoptic Airway Endoscopy in Anesthesia and Ctitical Care is a worthwhile addition to departmental, hospital, and medical school libraries. Allan P. Reed, MD
Assistant Professor of Clinical Anesthesiology Mount Sinai Medical Center New York, NY Advances in Pain Research and Therapy, Volume 15-Pediatrie Pain. Edited by Donald C. Tyler and Elliott J. Krane. Raven Press,
New York, NY, 1990,404 pp, $95.00. Recent advances in the understanding of pain in children has significantly changed the practice of anesthesiology. Surging interest in this area by multiple disciplines in the field of medicine has led to an improved understanding of pain, and its assessment and treatment. In this text, Drs Tyler and Krane, together with established investigators in the field of pain management, provide the scientific background and assessment methods as well as the clinical approach to acute and chronic pain management. Advances in Pain Research and Therapy-Pediattìc Pain is based on papers presented at the first International Symposium on Pediatrie Pain, which was held in Seattle, WA, in July 1988. This text reflects the complex nature of the biological basis of pain, and methods of assessment and treatment as studied by many professionals, including physician psychologists and nurses. In general, the text is well organized and thorough, covering all aspects of pediatrie pain in children, with up-to-date, thorough references. A distinctive hallmark of this text is the integration of pain assessment and the physiological response to pain with clinical aspects of acute pain management. The text is divided into six sections. The first section introduces the various methods of pain assessment and evaluation, discussing the various tools available and their strengths and weaknesses. It includes detailed reviews of the most common pain-assessment tools used in children. The second section emphasizes the biology of pain and its perception in the neonate. The remaining four sections of this text address pain management of the pediatrie patient. These sections detail current pain management with regard to (1) acute pain; (2) behavioral management; (3) chronic nonmalignant pain; and (4) cancer pain. Each of these sections highlights the pathophysiological processes involved in pain and addresses management techniques. The section on acute pain management reviewing regional techniques in children is the best from a clinical point of view. The discussions are wel1 written, practical, and nicely illustrated. Appropriately, this text concludes with a section on cancer pain management in children. This compendium of articles on pediatrie pain possesses the
breadth and depth necessary for the anesthesiologist interested in pediatrie pain management. All aspects of pain management and techniques currently used in children are presented in an organized manner. As such, this text is recommended for the anesthesiologist whose practice includes the perioperative anesthetic management of children. It would also serve as an excellent reference text for pediatrie pain in the general department of anesthesiology or pediatrics. For the practicing pediatrie cardiovascular anesthesiologist, the book has limited usefulness except for the discussion on pain in the neonate. In the preface Drs Tyler and Krane state their objective to “review the field of pediatrie pain and give the reader a feeling for what the current state of the art and state of thinking is with respect to research pursuits.” 1 believe this text admirably accomplishes this intention. Those disciplines involved in the perioperative care of the pediatrie patient will find it an invaluable resource to other major texts. William J. Greeley, MD
Associate Professor of Anesthesiology Associate Professor of Pediatrics Duke University Medical Center Durham, NC Advances in Pain Research and Therapy, Volume 14: Opioid Analgesia. Edited by C. Bennedetti, C.R. Chapman, and G. Giron.
Raven Press, New York, NY, 1990,450 pp. This book is the 14th in a series on advances in pain research and therapy. It represents papers based on a 2-day symposium entitled “Opioid Analgesia: Recent Advances in Systemic Administration,” which was held in 1987 under the international auspices of the study of pain, as a satellite symposium of the 5th World Congress on Pain. The book consists of 27 chapters divided into two parts. First, a section on fundamentals comprises chapters on basic mechanisms of opioid action, drug disposition, and the theoretical basis of controlled intravenous administration. The second, on clinical application, is divided into four sections on routes of administration, oral controlled morphine, patient-controlled analgesia, and summary presentations. This book suffers somewhat from the fact that the chapters are neither authoritative reviews nor scientific articles; they tend to fall somewhere in between. They generally present data from the standpoint of the authors, and the chapters are uneven in length and style. For example, the chapter entitled “Drug Disposition: Basic Pharmacokinetics” deals less with basic pharmacokinetics, but rather with the principles of sampling and measurement and with definitions in pharmacokinetics. In contrast, this reviewer found the chapter entitled “Studies on Opiate Transmission Lines and on Opiate-Monoamine Interactions in the Aged Rat Brain” a pure scientific article that belonged more in a monthly peer-reviewed journal. From the point of view of the cardiothoracic anesthesiologist. this book presents some useful historica1 information on the history of opium and its derivatives. It provides some insight into what the basic scientists are doing in the way of opioid research. The pharmacokinetic and dynamic material is generally presented better in other texts. The clinical applications are related to patient-controlled analgesia and oral controlled-release morphine. There are other single chapters on recta1 absorption, transnasal delivery, transdermal delivery, and sublingual opiates. There is also useful information on the use of systemic opioids for cancer pain. This boek would be appropriate to those interested in control of postoperative pain and in the therapy of cancer pain. However. the reviewer feels that it is of limited interest to the practicing cardiothoracic anesthesiologist. Peter S. Sebel, MB, BS, PhD, FFARCSI
Associate Professor of Anesthesiology Emory University School of Medicine Atlanta, GA
BOOK REVIEWS
performed from an external or internal approach. The internal method is briefly explained, but deserves a diagram to fully convey the means of performing this black. The external approach is ignored but certainly worthy of presentation. The amount and concentration of lidocaine recommended for transtracheal blockade are excessive. The text’s real strength emerges in two chapters devoted to the actual use of fiberscopes. Descriptions of flexible fiberoptic intubations in both sedated and anesthetized patients are excellent. Consideration is given to nasal and oral approaches in both instances. The discussion of frequent causes of flexible fiberoptic intubation failures should be helpful to novice endoscopists. The presentation of double-lumen tube placement and positioning confirmation by endoscopy is well written. Suggestions for endotracheal tube changes using fiberscopes are also valuable. Diagrams are clear and add to appreciation of the text. Most photographs are of excellent quality, but some are difficult to interpret and, consequently, fail to aid the reader. If not for the price, this work would be a reasonable purchase for practitioners of anesthesia and critical care medicine. As it stands. Fiberoptic Airway Endoscopy in Anesthesia and Ctitical Care is a worthwhile addition to departmental, hospital, and medical school libraries. Allan P. Reed, MD
Assistant Professor of Clinical Anesthesiology Mount Sinai Medical Center New York, NY Advances in Pain Research and Therapy, Volume 15-Pediatrie Pain. Edited by Donald C. Tyler and Elliott J. Krane. Raven Press,
New York, NY, 1990,404 pp, $95.00. Recent advances in the understanding of pain in children has significantly changed the practice of anesthesiology. Surging interest in this area by multiple disciplines in the field of medicine has led to an improved understanding of pain, and its assessment and treatment. In this text, Drs Tyler and Krane, together with established investigators in the field of pain management, provide the scientific background and assessment methods as well as the clinical approach to acute and chronic pain management. Advances in Pain Research and Therapy-Pediattìc Pain is based on papers presented at the first International Symposium on Pediatrie Pain, which was held in Seattle, WA, in July 1988. This text reflects the complex nature of the biological basis of pain, and methods of assessment and treatment as studied by many professionals, including physician psychologists and nurses. In general, the text is well organized and thorough, covering all aspects of pediatrie pain in children, with up-to-date, thorough references. A distinctive hallmark of this text is the integration of pain assessment and the physiological response to pain with clinical aspects of acute pain management. The text is divided into six sections. The first section introduces the various methods of pain assessment and evaluation, discussing the various tools available and their strengths and weaknesses. It includes detailed reviews of the most common pain-assessment tools used in children. The second section emphasizes the biology of pain and its perception in the neonate. The remaining four sections of this text address pain management of the pediatrie patient. These sections detail current pain management with regard to (1) acute pain; (2) behavioral management; (3) chronic nonmalignant pain; and (4) cancer pain. Each of these sections highlights the pathophysiological processes involved in pain and addresses management techniques. The section on acute pain management reviewing regional techniques in children is the best from a clinical point of view. The discussions are wel1 written, practical, and nicely illustrated. Appropriately, this text concludes with a section on cancer pain management in children. This compendium of articles on pediatrie pain possesses the
breadth and depth necessary for the anesthesiologist interested in pediatrie pain management. All aspects of pain management and techniques currently used in children are presented in an organized manner. As such, this text is recommended for the anesthesiologist whose practice includes the perioperative anesthetic management of children. It would also serve as an excellent reference text for pediatrie pain in the general department of anesthesiology or pediatrics. For the practicing pediatrie cardiovascular anesthesiologist, the book has limited usefulness except for the discussion on pain in the neonate. In the preface Drs Tyler and Krane state their objective to “review the field of pediatrie pain and give the reader a feeling for what the current state of the art and state of thinking is with respect to research pursuits.” 1 believe this text admirably accomplishes this intention. Those disciplines involved in the perioperative care of the pediatrie patient will find it an invaluable resource to other major texts. William J. Greeley, MD
Associate Professor of Anesthesiology Associate Professor of Pediatrics Duke University Medical Center Durham, NC Advances in Pain Research and Therapy, Volume 14: Opioid Analgesia. Edited by C. Bennedetti, C.R. Chapman, and G. Giron.
Raven Press, New York, NY, 1990,450 pp. This book is the 14th in a series on advances in pain research and therapy. It represents papers based on a 2-day symposium entitled “Opioid Analgesia: Recent Advances in Systemic Administration,” which was held in 1987 under the international auspices of the study of pain, as a satellite symposium of the 5th World Congress on Pain. The book consists of 27 chapters divided into two parts. First, a section on fundamentals comprises chapters on basic mechanisms of opioid action, drug disposition, and the theoretical basis of controlled intravenous administration. The second, on clinical application, is divided into four sections on routes of administration, oral controlled morphine, patient-controlled analgesia, and summary presentations. This book suffers somewhat from the fact that the chapters are neither authoritative reviews nor scientific articles; they tend to fall somewhere in between. They generally present data from the standpoint of the authors, and the chapters are uneven in length and style. For example, the chapter entitled “Drug Disposition: Basic Pharmacokinetics” deals less with basic pharmacokinetics, but rather with the principles of sampling and measurement and with definitions in pharmacokinetics. In contrast, this reviewer found the chapter entitled “Studies on Opiate Transmission Lines and on Opiate-Monoamine Interactions in the Aged Rat Brain” a pure scientific article that belonged more in a monthly peer-reviewed journal. From the point of view of the cardiothoracic anesthesiologist. this book presents some useful historica1 information on the history of opium and its derivatives. It provides some insight into what the basic scientists are doing in the way of opioid research. The pharmacokinetic and dynamic material is generally presented better in other texts. The clinical applications are related to patient-controlled analgesia and oral controlled-release morphine. There are other single chapters on recta1 absorption, transnasal delivery, transdermal delivery, and sublingual opiates. There is also useful information on the use of systemic opioids for cancer pain. This boek would be appropriate to those interested in control of postoperative pain and in the therapy of cancer pain. However. the reviewer feels that it is of limited interest to the practicing cardiothoracic anesthesiologist. Peter S. Sebel, MB, BS, PhD, FFARCSI
Associate Professor of Anesthesiology Emory University School of Medicine Atlanta, GA