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Nall International. Pp. 769; illustrated; indexed. Price £31.90.
BOOK REVIEWS
Obstetric Analgesia and Pennatology. By Ermelando V Cosmi. Published (1981) by Prenace/Nall International. Pp. 769; illustrated; indexed. Price £31.90. This book claims to present in detail the major problems encountered in the field of obstetric analgesia and anaesthesia and is intended for anaesthetists and for others who have entered the field of perinatal medicine The stated plan of the book is to review the older literature, to provide new information and to suggest guidelines for future developments. Because of the current trend to "natural childbirth" both the positive and negative aspects of the use of sedatives, analgesics and anaesthetics during labour are presented. An international team of 20 authors contribute 19 chapters of variable length. Inevitably the style of writing and ease of reading is uneven. The first six chapters deal with the psychological and physiological adaptations to pregnancy and parturition and include sections on psychoprophylaxis and hypnosis. Three chapters cover the effect of anaesthesia on uteroplacental blood flow, on labour and delivery and on the fetus. Other topics include hypertension and diabetes in pregnancy, management of preterm labour, and neonatal lung physiology and adaptation. By far the longest single contribution is the chapter on fetal homeostasis, extending to 216 pages with a vast list of 1388 references I Anaesthetists will find that this book is not a guide to techniques and may be disappointed by the lack of information on important topics. Regional Analgesia in Obstetrics occupies only 14 pages of text with 154 references.
The book is biased towards an American readership and current American practice of obstetric anaesthesia, as indicated by the chapter on hypertension in pregnancy, much of which is an elequent argument against the use of magnesium sulphate and in favour of methods commonly used m Britain. In a book of this nature some repetition cannot be avoided and if a topic is to be discussed from different points of view some contradiction is unpreventable, but sometimes confusing. The surprising statement, on the use of diazepam in qbitetrics, that no untoward effects on the mother or newborn have been found after the administration of doses as great as 100 mg (p 403), is fortunately challenged elsewhere in the book. Some of the chapters are inconclusive and present arguments, ideas and propositions rather than didactic advice on practical obstetric anaesthesia and analgesia. The last two are an exception, the penulpmate presenting a lucid account of the practical aspects of neonatal resuscitation. Melville K. Milne
OTHER BOOKS RECEIVED
Convergences Medicates, Tome 1, Nos. 1 and 2, 1982. Organe officiel de l'Association "Convergences" pour la publication de travaux medicaux convergents. No. Commission Paritaire 52346. Depot legal; 1 D tnmestre J982. Imprimerie P. Guichard, 4, rue E. Mattel - 42100 Saint-Eoenne
Downloaded from http://bja.oxfordjournals.org/ at New York University on April 18, 2015
the population is older than 75 years and furthermore, because only a small fraction of these undergo general anaesthesia, old age represents a relatively uncommon condition when considering general anaesthesia. I am sure the reader will recognize that, although elderly patients may only be a small fraction of the general population, they still constitute a large fraction of the hospital population, and therefore I cannot agree that old age is a rare condition when considering anaesthesia. I should like to illustrate the range within this book, not by considering the sections on muscle diseases, connective tissue diseases, neurological disease or skin and bone disorders, but rather by special reference to a single section—gastrointestinal disorders Like all sections this starts simply enough with a discussion of nausea and vomiting There are the details of neurophysiological control which are followed by a consideration of acid-base impairment. The information in this book is not always confined to rare conditions. A comment on the varieties of fistula is followed by analysis of the problems associated with gastrointestinal obstruction at different site? One finds here occasional rather teleologies! statements, although they may be emotionally satisfying, such as "in an attempt by the body to conserve HCO3. . ." While constipation, diarrhoea and gastrointestinal bleeding might not themselves be considered rare events they may result from uncommon diseases. However, the chapter does get into top gear with the aetiologies of malabsorptfon. As the reader proceeds distally down the oesophagus and beyond, syndromes tumble after one another, Boerhaaves, Barett's and Zollinger-Ellison are described, as are many others until finally we get back to vomiting. You may not agree absolutely with everything in this book, but there is a wealth of the unexpected diseases; not very common, any of them, but beware that 2 a.m. call from the registrar. T. E. ]. HtaXy
905
Obstetric Analgesia and Pennatology. By Ermelando V Cosmi. Published (1981) by Prenace/Nall International. Pp. 769; illustrated; indexed. Price £31.90. This book claims to present in detail the major problems encountered in the field of obstetric analgesia and anaesthesia and is intended for anaesthetists and for others who have entered the field of perinatal medicine The stated plan of the book is to review the older literature, to provide new information and to suggest guidelines for future developments. Because of the current trend to "natural childbirth" both the positive and negative aspects of the use of sedatives, analgesics and anaesthetics during labour are presented. An international team of 20 authors contribute 19 chapters of variable length. Inevitably the style of writing and ease of reading is uneven. The first six chapters deal with the psychological and physiological adaptations to pregnancy and parturition and include sections on psychoprophylaxis and hypnosis. Three chapters cover the effect of anaesthesia on uteroplacental blood flow, on labour and delivery and on the fetus. Other topics include hypertension and diabetes in pregnancy, management of preterm labour, and neonatal lung physiology and adaptation. By far the longest single contribution is the chapter on fetal homeostasis, extending to 216 pages with a vast list of 1388 references I Anaesthetists will find that this book is not a guide to techniques and may be disappointed by the lack of information on important topics. Regional Analgesia in Obstetrics occupies only 14 pages of text with 154 references.
The book is biased towards an American readership and current American practice of obstetric anaesthesia, as indicated by the chapter on hypertension in pregnancy, much of which is an elequent argument against the use of magnesium sulphate and in favour of methods commonly used m Britain. In a book of this nature some repetition cannot be avoided and if a topic is to be discussed from different points of view some contradiction is unpreventable, but sometimes confusing. The surprising statement, on the use of diazepam in qbitetrics, that no untoward effects on the mother or newborn have been found after the administration of doses as great as 100 mg (p 403), is fortunately challenged elsewhere in the book. Some of the chapters are inconclusive and present arguments, ideas and propositions rather than didactic advice on practical obstetric anaesthesia and analgesia. The last two are an exception, the penulpmate presenting a lucid account of the practical aspects of neonatal resuscitation. Melville K. Milne
OTHER BOOKS RECEIVED
Convergences Medicates, Tome 1, Nos. 1 and 2, 1982. Organe officiel de l'Association "Convergences" pour la publication de travaux medicaux convergents. No. Commission Paritaire 52346. Depot legal; 1 D tnmestre J982. Imprimerie P. Guichard, 4, rue E. Mattel - 42100 Saint-Eoenne
Downloaded from http://bja.oxfordjournals.org/ at New York University on April 18, 2015
the population is older than 75 years and furthermore, because only a small fraction of these undergo general anaesthesia, old age represents a relatively uncommon condition when considering general anaesthesia. I am sure the reader will recognize that, although elderly patients may only be a small fraction of the general population, they still constitute a large fraction of the hospital population, and therefore I cannot agree that old age is a rare condition when considering anaesthesia. I should like to illustrate the range within this book, not by considering the sections on muscle diseases, connective tissue diseases, neurological disease or skin and bone disorders, but rather by special reference to a single section—gastrointestinal disorders Like all sections this starts simply enough with a discussion of nausea and vomiting There are the details of neurophysiological control which are followed by a consideration of acid-base impairment. The information in this book is not always confined to rare conditions. A comment on the varieties of fistula is followed by analysis of the problems associated with gastrointestinal obstruction at different site? One finds here occasional rather teleologies! statements, although they may be emotionally satisfying, such as "in an attempt by the body to conserve HCO3. . ." While constipation, diarrhoea and gastrointestinal bleeding might not themselves be considered rare events they may result from uncommon diseases. However, the chapter does get into top gear with the aetiologies of malabsorptfon. As the reader proceeds distally down the oesophagus and beyond, syndromes tumble after one another, Boerhaaves, Barett's and Zollinger-Ellison are described, as are many others until finally we get back to vomiting. You may not agree absolutely with everything in this book, but there is a wealth of the unexpected diseases; not very common, any of them, but beware that 2 a.m. call from the registrar. T. E. ]. HtaXy
905