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Pediatric Trauma
BRITISH JOURNAL OF ANAESTHESIA
814
Donald Campbell
Sleep Apnea Syndromes. By C. Guilleminault and W. C. Dement. Published by Alan R. Liss Inc., New York. Pp. 390; illustrated; indexed. Price $34.00 Disorders of respiration during sleep are the subject of much current interest. This volume brings together 24 contributions, most of which were presented at a Conference in July 1977, providing a summary of present knowledge, techniques and hypotheses as an impetus to further research. The assembled papers cover aspects of sleep apnoea ranging from the symptomatology and physiology to the possible sites of obstruction and management. The papers by Lugaresi and colleagues on the clinical implications of snoring and by Henderson-Smart and Read on the vulnerability of the newborn to asphyxia illustrate the wider implications of an apparently esoteric subject. The detailed fibreoptic and polygraphic studies of the Stanford group elegantly display the site of airway obstruction during obstructive apnoea. The book closes with a general discussion and an appendix covering practical aspects of sleep monitoring. The editors have largely avoided the almost inevitable duplication of material and have neatly summarized the discussion which follows each paper. While unlikely to find a place on the shelves of department libraries, for those with an interest in the field this book represents an adequate summary of current knowledge and belief. The reference lists and practical advice render it a useful handbook and the many unanswered questions present a fertile course of future study. C. D. Harming Pain. Its Nature, Analysis and Treatment. By M. R. Bond. Published (1979) by Churchill Livingstone Medical Text. Pp. 186. Price £3.95. Pain is commonly regarded purely as a symptom of organic disease or injury. Professor Bond, in clear and concise terms, discusses the multifacetal nature of this complex, subjective experience and is at his best in dealing with the psychological, ethnic, social and environmental factors which influence pain behaviour. He emphasizes the importance of learning and personality traits and uses these as stepping stones to a chapter on the meaning of pain. There are introductory chapters on basic mechanisms and measurement followed, in Part II, by a clinical analysis of
this common symptom. Once again the highlights are interrelationships between pain, emotion, mental illness and physical behaviour. The last part deals with physical and psychological methods of pain relief. This eminently readable, modestly priced little book is written primarily for medical students in their final years and remedies a notable omission in the undergraduate curriculum. However, it should also be of considerable value and interest to a much wider circle of general practitioners, hospital doctors and nurses who are concerned in the management of pain patients. Certainly it should be compulsory reading for all anaesthetists and other workers in pain relief clinics and continuing care units. M. Mehta Pediatric Trauma. Edited by R. J. Touloukian. Published (1978) by John Wiley and Sons Inc. Pp. 637; illustrated; indexed. Price £24.95. Twenty-two contributors chosen by Professor Touloukian have combined with the aim of describing ".. .in comprehensive detail all important trauma problems encountered in infants and children". This immense task is dealt with by devoting the first 177 pages to general considerations, and the remainder is directed to a consideration of specific injuries. The early chapters contain information which is generally known to most workers and it is written in a rather superficial fashion. Some rather unnecessary line diagrams in Chapter 2 do nothing to dispel an impression of padding, and values quoted in ml/lb are irritating to a British reader. Most of the advice given with regard to evaluation and initial management are generalizations. The third chapter, on Psychologic Aspects, is well written and thoughtprovoking and the chapter on Radiologic Considerations presents a review of the x-ray changes which occur in trauma, of particular value to those who are not specialists in x-ray interpretation. Perhaps the chapter of most interest to anaesthetists is that devoted to anaesthesia and intensive care. Unfortunately, only 28 pages are allowed for the consideration of this aspect of the subject and the presentation is necessarily rather generalized. Some errors occur and are irritating to a reader, for example on p. 144 Dr Sellick's name is spelt with only one 1 and in the same paragraph atropine is said to be indicated in order to decrease gastric reflux. Cliches which can be annoying abound in the text and often are not meaningful—on p. 117 "anaesthetic techniques should be chosen which permit appropriate emergence". These criticisms apart, the chapter gives the reader a useful insight into anaesthetic attitudes and practice in this area. The sections of the book which are devoted to specific injuries are of very considerable interest and help to the non-surgical reader. As a background source of information for the anaesthetist they are invaluable. The section on cardiothoracic injuries is a good example and the information is well presented. The section devoted to injuries of the larynx and trachea, the subsequent complications and their treatment, can be singled out as an illustration of the useful information which many of these chapters contain. This book is, therefore, one which can be of value to the anaesthetist, particularly as a reference book, and in it he will find many aspects of the treatment of the injured child which are of value to him. John Inkster
Primed in Great Britain by John Wright and Sons Ltd. at The Stonebridge Press, Bristol BS4 5NU
© Macmillan Journals Ltd 1979
Downloaded from http://bja.oxfordjournals.org/ at Boston University on June 29, 2015
result of intensive research a great number of new compounds have been released and more are no doubt on the way. This little book by Professor Parkhouse and his colleagues does more than classify the narcotic and antipyretic analgesics and elucidate their mechanisms of action and general pharmacology but, for good measure, includes an introductory chapter on the mechanisms of pain which is a model of brevity and clarity. The final section provides guidance on the statistical design and pitfalls of controlled clinical trials and should be compulsory reading for all those wishing to embark on these often troubled waters. The reviewer has only one minor criticism and that is that even this excellent monograph cannot hope to keep pace with all the recent advances, particularly new work on the endorphins and enkephalins. Two appendices, one on statistical samples and the other a tabular classification of the available drugs with their trade names and dosage, complete this text which is highly recommended.
814
Donald Campbell
Sleep Apnea Syndromes. By C. Guilleminault and W. C. Dement. Published by Alan R. Liss Inc., New York. Pp. 390; illustrated; indexed. Price $34.00 Disorders of respiration during sleep are the subject of much current interest. This volume brings together 24 contributions, most of which were presented at a Conference in July 1977, providing a summary of present knowledge, techniques and hypotheses as an impetus to further research. The assembled papers cover aspects of sleep apnoea ranging from the symptomatology and physiology to the possible sites of obstruction and management. The papers by Lugaresi and colleagues on the clinical implications of snoring and by Henderson-Smart and Read on the vulnerability of the newborn to asphyxia illustrate the wider implications of an apparently esoteric subject. The detailed fibreoptic and polygraphic studies of the Stanford group elegantly display the site of airway obstruction during obstructive apnoea. The book closes with a general discussion and an appendix covering practical aspects of sleep monitoring. The editors have largely avoided the almost inevitable duplication of material and have neatly summarized the discussion which follows each paper. While unlikely to find a place on the shelves of department libraries, for those with an interest in the field this book represents an adequate summary of current knowledge and belief. The reference lists and practical advice render it a useful handbook and the many unanswered questions present a fertile course of future study. C. D. Harming Pain. Its Nature, Analysis and Treatment. By M. R. Bond. Published (1979) by Churchill Livingstone Medical Text. Pp. 186. Price £3.95. Pain is commonly regarded purely as a symptom of organic disease or injury. Professor Bond, in clear and concise terms, discusses the multifacetal nature of this complex, subjective experience and is at his best in dealing with the psychological, ethnic, social and environmental factors which influence pain behaviour. He emphasizes the importance of learning and personality traits and uses these as stepping stones to a chapter on the meaning of pain. There are introductory chapters on basic mechanisms and measurement followed, in Part II, by a clinical analysis of
this common symptom. Once again the highlights are interrelationships between pain, emotion, mental illness and physical behaviour. The last part deals with physical and psychological methods of pain relief. This eminently readable, modestly priced little book is written primarily for medical students in their final years and remedies a notable omission in the undergraduate curriculum. However, it should also be of considerable value and interest to a much wider circle of general practitioners, hospital doctors and nurses who are concerned in the management of pain patients. Certainly it should be compulsory reading for all anaesthetists and other workers in pain relief clinics and continuing care units. M. Mehta Pediatric Trauma. Edited by R. J. Touloukian. Published (1978) by John Wiley and Sons Inc. Pp. 637; illustrated; indexed. Price £24.95. Twenty-two contributors chosen by Professor Touloukian have combined with the aim of describing ".. .in comprehensive detail all important trauma problems encountered in infants and children". This immense task is dealt with by devoting the first 177 pages to general considerations, and the remainder is directed to a consideration of specific injuries. The early chapters contain information which is generally known to most workers and it is written in a rather superficial fashion. Some rather unnecessary line diagrams in Chapter 2 do nothing to dispel an impression of padding, and values quoted in ml/lb are irritating to a British reader. Most of the advice given with regard to evaluation and initial management are generalizations. The third chapter, on Psychologic Aspects, is well written and thoughtprovoking and the chapter on Radiologic Considerations presents a review of the x-ray changes which occur in trauma, of particular value to those who are not specialists in x-ray interpretation. Perhaps the chapter of most interest to anaesthetists is that devoted to anaesthesia and intensive care. Unfortunately, only 28 pages are allowed for the consideration of this aspect of the subject and the presentation is necessarily rather generalized. Some errors occur and are irritating to a reader, for example on p. 144 Dr Sellick's name is spelt with only one 1 and in the same paragraph atropine is said to be indicated in order to decrease gastric reflux. Cliches which can be annoying abound in the text and often are not meaningful—on p. 117 "anaesthetic techniques should be chosen which permit appropriate emergence". These criticisms apart, the chapter gives the reader a useful insight into anaesthetic attitudes and practice in this area. The sections of the book which are devoted to specific injuries are of very considerable interest and help to the non-surgical reader. As a background source of information for the anaesthetist they are invaluable. The section on cardiothoracic injuries is a good example and the information is well presented. The section devoted to injuries of the larynx and trachea, the subsequent complications and their treatment, can be singled out as an illustration of the useful information which many of these chapters contain. This book is, therefore, one which can be of value to the anaesthetist, particularly as a reference book, and in it he will find many aspects of the treatment of the injured child which are of value to him. John Inkster
Primed in Great Britain by John Wright and Sons Ltd. at The Stonebridge Press, Bristol BS4 5NU
© Macmillan Journals Ltd 1979
Downloaded from http://bja.oxfordjournals.org/ at Boston University on June 29, 2015
result of intensive research a great number of new compounds have been released and more are no doubt on the way. This little book by Professor Parkhouse and his colleagues does more than classify the narcotic and antipyretic analgesics and elucidate their mechanisms of action and general pharmacology but, for good measure, includes an introductory chapter on the mechanisms of pain which is a model of brevity and clarity. The final section provides guidance on the statistical design and pitfalls of controlled clinical trials and should be compulsory reading for all those wishing to embark on these often troubled waters. The reviewer has only one minor criticism and that is that even this excellent monograph cannot hope to keep pace with all the recent advances, particularly new work on the endorphins and enkephalins. Two appendices, one on statistical samples and the other a tabular classification of the available drugs with their trade names and dosage, complete this text which is highly recommended.