Pediatric Anesthesia Practice
Pediatric Anaesthesia Practice. R. S. Litman (editor). Published by Cambridge University Press, Cambridge, UK. Pp. 216 . Price £27.99. ISBN 9780521709378.This is one of those pocket books that are intended to be carried at all times as an aide memoire for the anaesthetist who has the basic skills but may not remember the fine detail of a particular procedure. It is divided into three sections: the first covers co-existing diseases which the anaesthetist may encounter in children, the second section covers anaesthesia for approximately 100 surgical procedures, and the book concludes with a section on regional anaesthesia.
The first section on co-existing diseases covers 30 conditions, some of which, mainly the cardiac abnormalities, are covered again in the anaesthesia section. There appears to be no cross-referencing between the disease section and the anaesthesia section. Unfortunately, some common paediatric conditions such as diabetes mellitus and osteogenesis imperfecta are not covered in this section.
The section on anaesthesia is arranged alphabetically rather than by physiological system so myelomeningocele, is followed by myringotomy, is followed by necrotising enterocolitis. This makes it quite difficult to quickly access information should the reader's nomenclature differ from that of the author. For example, airway endoscopy does not appear under ‘bronchoscopy’ or under ‘inhaled foreign body’; it is under ‘foreign body in the trachea’. Similarly, ‘fundoplication’ is found under ‘Nissen fundoplication’. I think the book would be enhanced if a cross-referencing system was used so that readers could quickly find the condition they are seeking.
There is an extensive use of abbreviations throughout the book with no glossary. Some of them are in common use, others such as ‘LYTES’ and ‘q6h’ are readily understood by anybody who watches ER. I know that BUN is not necessarily a small cake taken with afternoon tea but I was baffled by CHF, H/H, NPO:std, T&C, and T&S.
The junior anaesthetist frequently requires clear, unequivocal help and some general advice on fluid management and analgesia would I am sure have been a useful section in the book.
The section on regional anaesthesia runs to a mere three pages. It only covers epidurals and spinals and gives no advice on drug dose.
Having said all that, the individual guidance for procedures is very helpful, each uniformly classified in a logical order of co-existing diseases, preoperative, procedural considerations, anaesthetic plan, pain management, and postoperative considerations. Curiously, there are two sections on anaesthesia for MRI scans.
A book of this type needs to be up-to-date, accessible, and cut through the unnecessary or inaccurate information which can be thrown up by an internet search engine.
All in all, I am sure that this book is well suited for anaesthetic trainees in the editor's institution. However, I am not sure how applicable it is to centres outside this one and feel that the nomenclature and abbreviations will make it relatively difficult for European anaesthetists to use.
Personally, I would have preferred a systematic organization of subject matter rather than an alphabetical one. I would have welcomed more information on regional analgesia and a formulary of drug doses and fluid regimes. This could be an excellent little book if its contents were more accessible.
Sheffield, UK
E-mail: I.barker{at}sheffield.ac.uk
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