- Email: [email protected]
Pain Management
j o u r n a l o f s u r g i c a l r e s e a r c h 1 7 9 ( 2 0 1 3 ) 2 2 e2 3
Available online at www.sciencedirect.com
journal homepage: www.JournalofSurgicalResearch.com
Book review Pain Management. Steven D. Waldman, MD, JD. Philadelphia, PA: Elsevier Saunders, 2011. Hardcover. 1445 pages. Upon opening this book, it is immediately striking as to the breadth in which the title delves into pain management. As with most topics in medicine, depth and breadth are often exchanged, as off-the-shelf references must be concise to be acutely useful, but detailed enough to provide the clinician with adequate, evidence-based material that complements the clinician’s knowledge base. This text trades some of the more extensive details for a broader base, and while there are a few exceptions, the balance the author has struck allows for an excellent reference for clinicians in all specialties that deal with pain on some level. Section I outlines the basic anatomic pathways and chemical-physiologic mechanisms that underlay the feeling known as “pain.” While basic understanding is required of these elaborate frameworks, specific chemical receptors, and physiology, the text goes slightly beyond what is necessary in most clinical practicesdas illustrated by analysis of the cited research showing plasticity of pain response with “greater activity in the anterior cingulate” (page 17). Given the overall lack of applicability to clinical practice, this information is interesting but ultimately not terribly important to apply to a patient who is post-op day one following uneventful appendectomy, for example. However, the 35 or so pages do not weigh heavily towards the complete text, and provide an appropriately detailed basis of chemical and biologic pain pathways. While the author does an excellent job of balancing depth with breadth, section II has proven to be the exception in that the detail into which the author delves proves to be excessive in terms of its utility. Specific imaging modalities are referenced for diagnosis of specific pain syndromes, which is imaginably only useful in a pain-centered practice. However, if that is the case, detailed analysis of commonly occurring pain syndromes is paramount, and is adequately addressed in the text. Useful imaging examples are found as well, and they do not clutter the message, but rather enhance diagnosis and treatment. Specifically, chapter 17 focuses on neural blockade as a diagnostic tool for pain syndromes. While the text does not describe techniques or include descriptions of procedures, several distinct nerve blocks are mentioned as superb methods of diagnosing disease when other methods have failed. Simultaneously, however, it is worth noting that the author makes specific note to use
caution, as invasive procedures as diagnostic tools can lead to significant morbidity. As the text continues, regional pain syndromes are explored and are appropriately broken down by system in a useful reference for a broad range of practice scopes. Exquisitely useful is the head-to-toe format, in which a brief synopsis on clinical presentation, differentials, treatments, and often evidence is presented in a consistently organized manner, lending to an extraordinarily useful, anatomically based approach. The head and face pain syndromes are explored in detail, followed by neck, back, torso, and extremities. Each discrete block has substantial information regarding the pain syndrome under discussion, and the simple fact that the syndromes are simply based on location allows for easy reference during clinical practice. Finally, the text finishes with a substantial volumed greater than one-thirdddevoted to the express purpose of treatment of the preceding pain syndromes as well as those more exclusively treated by procedures. As the book title is, of course, regarding the management of pain, it is wholly appropriate to devote the plurality of the text to the clinical treatment. Again, however, this does not necessarily lead to utility in clinical practice, as few specialties will utilize advanced nerve blocks or therapies such as cryoneurolysis. Additionally, as with all written references, there exists a lag of information between practice guidelines at time of draft and time of publication. The recent development of intravenous acetaminophen will surely provide a useful adjunct for people who do not tolerate opioid analgesia but are unable to tolerate oral or rectal formularies, but this is not mentioned in the text whatsoever. This simply iterates the fact that electronic resources must be utilized to augment print resources in contemporary practice. Despite this, the idea of multiple modalities for treatment of pain is clearly expressed to the reader. In section IV, for example, peripheral pain due to repetitive strain injury is explored, and medical management is suggested as a first line of treatment. Additionally, although used more acutely for local anesthesia, neural blockade is often warranted for diagnoses of pain syndromes (i.e., ulnar nerve blockade) otherwise elusive to the clinician. In conclusion, the text would find a useful place in the repertoire of any clinician who regularly deals with treatment of pain; and whether it is postoperative or an atypical presentation of a common ailment such as a muscular strain, the reference utility of Pain Management would not be lost
j o u r n a l o f s u r g i c a l r e s e a r c h 1 7 9 ( 2 0 1 3 ) 2 2 e2 3
upon practitioners of nearly all specialties. If nothing else, pain presentations that the clinicians themselves would not treat would allow for a more complete clinical picture, and allow correct and efficient consultation of further services. We recommend this text primarily to those specialties that treat acute or chronic pain as a practice choice more so than those who treat pain in other settings. Jeffrey T. Kokott MD Department of Anesthesiology University of Wisconsin Hospitals and Clinics Madison, Wisconsin
23
Michael V. Tirabassi MD* Section of Pediatric Surgery University of Wisconsin School of Medicine and Public Health Madison, Wisconsin *Corresponding author. Section of Pediatric Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792, USA. Tel.: þ1 608 609 3194. E-mail address: [email protected] (M. V. Tirabassi) Available online 2 June 2012 0022-4804/$ e see front matter doi:10.1016/j.jss.2012.05.023
Available online at www.sciencedirect.com
journal homepage: www.JournalofSurgicalResearch.com
Book review Pain Management. Steven D. Waldman, MD, JD. Philadelphia, PA: Elsevier Saunders, 2011. Hardcover. 1445 pages. Upon opening this book, it is immediately striking as to the breadth in which the title delves into pain management. As with most topics in medicine, depth and breadth are often exchanged, as off-the-shelf references must be concise to be acutely useful, but detailed enough to provide the clinician with adequate, evidence-based material that complements the clinician’s knowledge base. This text trades some of the more extensive details for a broader base, and while there are a few exceptions, the balance the author has struck allows for an excellent reference for clinicians in all specialties that deal with pain on some level. Section I outlines the basic anatomic pathways and chemical-physiologic mechanisms that underlay the feeling known as “pain.” While basic understanding is required of these elaborate frameworks, specific chemical receptors, and physiology, the text goes slightly beyond what is necessary in most clinical practicesdas illustrated by analysis of the cited research showing plasticity of pain response with “greater activity in the anterior cingulate” (page 17). Given the overall lack of applicability to clinical practice, this information is interesting but ultimately not terribly important to apply to a patient who is post-op day one following uneventful appendectomy, for example. However, the 35 or so pages do not weigh heavily towards the complete text, and provide an appropriately detailed basis of chemical and biologic pain pathways. While the author does an excellent job of balancing depth with breadth, section II has proven to be the exception in that the detail into which the author delves proves to be excessive in terms of its utility. Specific imaging modalities are referenced for diagnosis of specific pain syndromes, which is imaginably only useful in a pain-centered practice. However, if that is the case, detailed analysis of commonly occurring pain syndromes is paramount, and is adequately addressed in the text. Useful imaging examples are found as well, and they do not clutter the message, but rather enhance diagnosis and treatment. Specifically, chapter 17 focuses on neural blockade as a diagnostic tool for pain syndromes. While the text does not describe techniques or include descriptions of procedures, several distinct nerve blocks are mentioned as superb methods of diagnosing disease when other methods have failed. Simultaneously, however, it is worth noting that the author makes specific note to use
caution, as invasive procedures as diagnostic tools can lead to significant morbidity. As the text continues, regional pain syndromes are explored and are appropriately broken down by system in a useful reference for a broad range of practice scopes. Exquisitely useful is the head-to-toe format, in which a brief synopsis on clinical presentation, differentials, treatments, and often evidence is presented in a consistently organized manner, lending to an extraordinarily useful, anatomically based approach. The head and face pain syndromes are explored in detail, followed by neck, back, torso, and extremities. Each discrete block has substantial information regarding the pain syndrome under discussion, and the simple fact that the syndromes are simply based on location allows for easy reference during clinical practice. Finally, the text finishes with a substantial volumed greater than one-thirdddevoted to the express purpose of treatment of the preceding pain syndromes as well as those more exclusively treated by procedures. As the book title is, of course, regarding the management of pain, it is wholly appropriate to devote the plurality of the text to the clinical treatment. Again, however, this does not necessarily lead to utility in clinical practice, as few specialties will utilize advanced nerve blocks or therapies such as cryoneurolysis. Additionally, as with all written references, there exists a lag of information between practice guidelines at time of draft and time of publication. The recent development of intravenous acetaminophen will surely provide a useful adjunct for people who do not tolerate opioid analgesia but are unable to tolerate oral or rectal formularies, but this is not mentioned in the text whatsoever. This simply iterates the fact that electronic resources must be utilized to augment print resources in contemporary practice. Despite this, the idea of multiple modalities for treatment of pain is clearly expressed to the reader. In section IV, for example, peripheral pain due to repetitive strain injury is explored, and medical management is suggested as a first line of treatment. Additionally, although used more acutely for local anesthesia, neural blockade is often warranted for diagnoses of pain syndromes (i.e., ulnar nerve blockade) otherwise elusive to the clinician. In conclusion, the text would find a useful place in the repertoire of any clinician who regularly deals with treatment of pain; and whether it is postoperative or an atypical presentation of a common ailment such as a muscular strain, the reference utility of Pain Management would not be lost
j o u r n a l o f s u r g i c a l r e s e a r c h 1 7 9 ( 2 0 1 3 ) 2 2 e2 3
upon practitioners of nearly all specialties. If nothing else, pain presentations that the clinicians themselves would not treat would allow for a more complete clinical picture, and allow correct and efficient consultation of further services. We recommend this text primarily to those specialties that treat acute or chronic pain as a practice choice more so than those who treat pain in other settings. Jeffrey T. Kokott MD Department of Anesthesiology University of Wisconsin Hospitals and Clinics Madison, Wisconsin
23
Michael V. Tirabassi MD* Section of Pediatric Surgery University of Wisconsin School of Medicine and Public Health Madison, Wisconsin *Corresponding author. Section of Pediatric Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792, USA. Tel.: þ1 608 609 3194. E-mail address: [email protected] (M. V. Tirabassi) Available online 2 June 2012 0022-4804/$ e see front matter doi:10.1016/j.jss.2012.05.023