British Journal of Anaesthesia, 2003, Vol. 90, No. 1 112
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia
Book Review |
Clinical Anesthesia Procedures of the Massachusetts General Hospital, 6th Edn.
Bristol, UK
Clinical Anesthesia Procedures of the Massachusetts General Hospital, 6th Edn.
M. T. Bailin, J. K. Davison, K. L. Haspel, C. Roscow, S. A. Vassallo (associate editors), and W. E. Hurford (senior editor).
Published by Lippincott Williams and Wilkins, Philadelphia.
Pp. 786; indexed; illustrated. Price £30.00. ISBN 0-7817-3718-4.
This excellent book, now in its sixth edition, is very much the residents’ anaesthetic bible in the USA. Being the product of a single university teaching hospital, it does not suffer from some of the editorial confusion seen in larger multi-author books and yet, surprisingly, there is little cross-referencing between sections. It is not a book that one reads, cover to cover, while studying for an examination, but rather is a comprehensive ‘white coat pocket’ book for immediate reference.
It is divided into three main sections, evaluating the patient before anaesthesia, administration of anaesthesia, and perioperative issues. In the first, apart from preoperative evaluation, there are chapters related to cardiac, pulmonary, renal, hepatic and endocrine disease, which are all very comprehensive. A significant omission is anything related to neurological disease, including anaesthesia in conditions such as epilepsy and the various neuropathies. (Indeed, the only mention of epilepsy is a very brief reference to anaesthesia for epilepsy surgery.) The chapters are easy to read with all the main headings and subheadings in bold type, and, when used in conjunction with the comprehensive index at the back, it is usually easy to find the relevant information, using a keyword technique.
The middle section on administration of anaesthesia is the largest and is broken down into the various anaesthetic subspecialities, together with specific chapters on i.v. and inhalation anaesthetics, neuromuscular block, and airway management. There are also sections on neuraxial techniques and regional anaesthesia, though the latter is relatively brief and not sufficiently comprehensive to teach regional blocks. Having said this, if this book is a first line handbook, then the need to depend upon a more detailed text in certain situations is understandable.
In trying to assess the comprehensiveness of the book, I used it as a handbook, carrying it around for several weeks and searching for relevant information in a variety of clinical situations. Under electroconvulsive therapy (ECT) anaesthesia, I was disappointed to see that the main induction agent recommended was methohexital, which is no longer available. There is only a passing reference to propofol and no mention of its disadvantages for ECT anaesthesia. Patients on venlafaxine and moclobemide were not discussed, both of which are very relevant to UK ECT anaesthetic practice.
Diabetes is extensively covered as one would expect, but here one notices the difference between American and English text—the units for blood sugar are not the same. Other sections covered well are those relating to LMAs, and particularly to extubation and its problems. There is also a useful section on the inter-relationships between herbal therapy and anaesthesia. By contrast, the section on anaphylaxis is exceedingly short, less than one page in total, and there is nothing about the long-term management or testing of such patients. Another surprising omission is any mention of venous thrombosis prophylaxis, using either mechanical or pharmacological methods. Heparin is mentioned in other contexts, but an extensive search of the index failed to provide anything to guide the reader towards patients at risk, or the possible preventative methods available. By contrast, the section on neuraxial blocks and anticoagulation was suitably comprehensive.
The final section includes a large chapter on the postanaesthesia care unit, which is really postoperative care and its complications. The chapter on acute pain is also very relevant, but the small section at the end on chronic pain is insufficient for any real educational purpose. The section on radiological anaesthesia for magnetic resonance imaging and computed tomography scanning is also relatively small, particularly as this is now a major part of anaesthesia outside the operating theatre.
Although this book is entirely aimed at an American audience and is the product of one major American teaching hospital, its usefulness is certainly not restricted in that way. Some of the pharmacology is inevitably slightly different from that used in the UK, but nevertheless the anaesthetic techniques and descriptions are entirely relevant to normal clinical practice. Although designed as a reference book, it is easy to read in short sections and is succinct and relevant. Disappointingly, it contains virtually no illustrations, drawings or tables. In many ways, it is similar to our own ‘Synopsis of Anaesthesia’ and, bearing in mind that the latter is entirely designed for a UK readership, perhaps it is the more sensible purchase. However, this book is much more compact and easy to carry around and for that reason, although it weighs 0.5 kg, it may be an excellent alternative.
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||