- Email: [email protected]
Peripheral Regional Anaesthesia: An Atlas of Anatomy and Techniques
Book Reviews
and the IARS, and created an International College of Anesthetists to certify specialists. His power and influence were such that the American Medical Association were unwilling to aid (physician) anaesthetists for fear McMechan would be in sole control. On his death the ASA were released from a ‘secret’ agreement that prevented them from publishing a journal or undertaking congresses while the International and associated Societies held theirs. Thus, the birth of anaesthesiology in 1940 was a consequence of McMechan’s death in 1939. It is difficult to imagine nowadays how one man could have wielded such power for 25 yr. The later chapters describe the rapid growth in membership of the Society and the development of the highly successful annual meetings. The leadership of the ASA has responded to a variety of challenges in recent decades from poor recruitment to the specialty, educational programmes for residents, maintenance of independent practice for anaesthesiologists, battles with nurse anaesthetists, to priming money for young researchers. It is salutary to read that political lobbying at Washington has been the main activity of some presidents in recent years. The book is a celebration, rightly so, and I looked in vain for a hint of criticism of the bygone leaders of anaesthesiology. It was only in a chapter by Selma Harrison Calmes pointing out the poor representation of women in the ASA hierarchy that I found mention of disharmony. Virginia Apgar was Treasurer of the ASA from 1940 and was in conflict (‘vicious exchange’) with Paul Wood over the management of the finances (elsewhere Paul Wood is rightly hailed as a major force in the development of the ASA). The accounts show that Virginia Apgar’s views were correct and by the end of her tenure of office the ASA was in a sound financial position. It is difficult to believe that similar arguments between powerful personalities did not take place. This book is an enjoyable read, even to a non-historian. I assume that the details are accurate, the authors have no excuses as they had access to the Wood-Library Museum. I am no longer persuaded that an interest in the history of anaesthesia indicates imminent academic demise, although clinical audit remains mostly a worthless occupation. (‘Great to see a . . . rolling programme of audit—Keep up the good work!’ from an audit inspection of Harold Shipman 9 months before his arrest for murder. Lancet 2003, 362, 586.) Finally, I am sure that many anaesthetists and anaesthesiologists would like to offer congratulations to the ASA on their centenary. This book is an admirable tribute to many of the great pioneers of the specialty. G. M. Hall London, UK E-mail: [email protected] doi:10.1093/bja/ael022
Peripheral Regional Anaesthesia: An Atlas of Anatomy and Techniques. G. Meier and J. Buettner (editors). Published by Thieme Verlag, Stuttgart, Germany. Pp. 251; indexed; illustrated. Price £80.00; ¤119.95. ISBN 3-13-139791-8. This book represents a welcome addition to the currently available texts on regional anaesthesia. As the title suggests, this is not meant to be a comprehensive textbook of regional anaesthesia but one that focuses on peripheral blocks of the upper and lower limb. It does not cover blocks of the trunk or the head and neck. The publication reflects growing interest in peripheral regional techniques for both operative surgery and postoperative analgesia and manages to pull together many of the more recent advances in approach and performance that have appeared in the literature over the last few years. This is in itself a useful task, given the number and variety of approaches to the infraclavicular block alone which have appeared in the journals. From that perspective, it is obvious that the authors have examined the evidence regarding efficacy and complications to arrive at a fair balance between hard fact and what is inevitably their own personal preference. It is clear on examining the text that the authors have considerable practical experience with these techniques, which is essential in preparing a book of this type. The block choices and descriptions are wonderfully complemented by some excellent illustrations as well as photographs of the cadaveric anatomy, surface anatomy, radiological and MRI images, and needle positions. A few ultrasonic images are also included for completeness. One particularly useful feature is having adjacent images of cadaveric anatomy; ‘living’ surface anatomy and coloured illustration, all produced to the same scale, side by side, allowing a greater appreciation of the anatomical basis of each approach. The book begins with a general overview of upper limb regional anaesthesia covering the major approaches to interscalene block, including the Meier technique and dorsal approach of Pippa. Infraclavicular block is then described in detail, concentrating on the vertical infraclavicular approach and the Borgeat modification. This is followed by suprascapular, axillary block and selective blocks of the distal upper limb. Interestingly, supraclavicular block is ignored, which probably reflects its continuing decline in popularity in favour of approaches below the clavicle. The second section of the book concentrates on the lower limb with sections in turn describing psoas compartment, femoral block, a variety of sciatic blocks including supine, lateral and popliteal approaches, ending with peripheral blocks around the hip, knee and ankle. The final section examines more general considerations relating to performance and complications of peripheral blocks and includes information on continuous infusion techniques and ultrasonic location. All in all then a pretty impressive and comprehensive read and one which is fabulously illustrated. The novice
543
Book Reviews
anaesthetist would probably prefer a more comprehensive text containing information relating to neuraxial and all peripheral blocks, but for those specialist or trainee anaesthetists with an interest in peripheral limb blocks whether for surgery or analgesia, this may well be the text for you. It is up to date, selects blocks of current interest with a good evidence base for efficacy and is filled with practical tips and guides as well as the superb illustrations. Every department with an interest in regional anaesthesia should have one. D. M. Coventry Dundee, UK E-mail: [email protected] doi:10.1093/bja/ael023
544
and the IARS, and created an International College of Anesthetists to certify specialists. His power and influence were such that the American Medical Association were unwilling to aid (physician) anaesthetists for fear McMechan would be in sole control. On his death the ASA were released from a ‘secret’ agreement that prevented them from publishing a journal or undertaking congresses while the International and associated Societies held theirs. Thus, the birth of anaesthesiology in 1940 was a consequence of McMechan’s death in 1939. It is difficult to imagine nowadays how one man could have wielded such power for 25 yr. The later chapters describe the rapid growth in membership of the Society and the development of the highly successful annual meetings. The leadership of the ASA has responded to a variety of challenges in recent decades from poor recruitment to the specialty, educational programmes for residents, maintenance of independent practice for anaesthesiologists, battles with nurse anaesthetists, to priming money for young researchers. It is salutary to read that political lobbying at Washington has been the main activity of some presidents in recent years. The book is a celebration, rightly so, and I looked in vain for a hint of criticism of the bygone leaders of anaesthesiology. It was only in a chapter by Selma Harrison Calmes pointing out the poor representation of women in the ASA hierarchy that I found mention of disharmony. Virginia Apgar was Treasurer of the ASA from 1940 and was in conflict (‘vicious exchange’) with Paul Wood over the management of the finances (elsewhere Paul Wood is rightly hailed as a major force in the development of the ASA). The accounts show that Virginia Apgar’s views were correct and by the end of her tenure of office the ASA was in a sound financial position. It is difficult to believe that similar arguments between powerful personalities did not take place. This book is an enjoyable read, even to a non-historian. I assume that the details are accurate, the authors have no excuses as they had access to the Wood-Library Museum. I am no longer persuaded that an interest in the history of anaesthesia indicates imminent academic demise, although clinical audit remains mostly a worthless occupation. (‘Great to see a . . . rolling programme of audit—Keep up the good work!’ from an audit inspection of Harold Shipman 9 months before his arrest for murder. Lancet 2003, 362, 586.) Finally, I am sure that many anaesthetists and anaesthesiologists would like to offer congratulations to the ASA on their centenary. This book is an admirable tribute to many of the great pioneers of the specialty. G. M. Hall London, UK E-mail: [email protected] doi:10.1093/bja/ael022
Peripheral Regional Anaesthesia: An Atlas of Anatomy and Techniques. G. Meier and J. Buettner (editors). Published by Thieme Verlag, Stuttgart, Germany. Pp. 251; indexed; illustrated. Price £80.00; ¤119.95. ISBN 3-13-139791-8. This book represents a welcome addition to the currently available texts on regional anaesthesia. As the title suggests, this is not meant to be a comprehensive textbook of regional anaesthesia but one that focuses on peripheral blocks of the upper and lower limb. It does not cover blocks of the trunk or the head and neck. The publication reflects growing interest in peripheral regional techniques for both operative surgery and postoperative analgesia and manages to pull together many of the more recent advances in approach and performance that have appeared in the literature over the last few years. This is in itself a useful task, given the number and variety of approaches to the infraclavicular block alone which have appeared in the journals. From that perspective, it is obvious that the authors have examined the evidence regarding efficacy and complications to arrive at a fair balance between hard fact and what is inevitably their own personal preference. It is clear on examining the text that the authors have considerable practical experience with these techniques, which is essential in preparing a book of this type. The block choices and descriptions are wonderfully complemented by some excellent illustrations as well as photographs of the cadaveric anatomy, surface anatomy, radiological and MRI images, and needle positions. A few ultrasonic images are also included for completeness. One particularly useful feature is having adjacent images of cadaveric anatomy; ‘living’ surface anatomy and coloured illustration, all produced to the same scale, side by side, allowing a greater appreciation of the anatomical basis of each approach. The book begins with a general overview of upper limb regional anaesthesia covering the major approaches to interscalene block, including the Meier technique and dorsal approach of Pippa. Infraclavicular block is then described in detail, concentrating on the vertical infraclavicular approach and the Borgeat modification. This is followed by suprascapular, axillary block and selective blocks of the distal upper limb. Interestingly, supraclavicular block is ignored, which probably reflects its continuing decline in popularity in favour of approaches below the clavicle. The second section of the book concentrates on the lower limb with sections in turn describing psoas compartment, femoral block, a variety of sciatic blocks including supine, lateral and popliteal approaches, ending with peripheral blocks around the hip, knee and ankle. The final section examines more general considerations relating to performance and complications of peripheral blocks and includes information on continuous infusion techniques and ultrasonic location. All in all then a pretty impressive and comprehensive read and one which is fabulously illustrated. The novice
543
Book Reviews
anaesthetist would probably prefer a more comprehensive text containing information relating to neuraxial and all peripheral blocks, but for those specialist or trainee anaesthetists with an interest in peripheral limb blocks whether for surgery or analgesia, this may well be the text for you. It is up to date, selects blocks of current interest with a good evidence base for efficacy and is filled with practical tips and guides as well as the superb illustrations. Every department with an interest in regional anaesthesia should have one. D. M. Coventry Dundee, UK E-mail: [email protected] doi:10.1093/bja/ael023
544