The Pediatric Anesthesia Handbook. Edited by Charlotte Bell and Zeev N. Kain with Cindy Hughes as visiting editor. St. Louis, Mosby, 1997. Pages: 700. Price:$44.95.

This is the second edition of the Pediatric Anesthesia Handbook designed to provide a comprehensive review of the practice of anesthesia in children. It is another one in the series of practical handbooks published by Mosby. The text consists of 23 chapters divided in three main sections and also includes 6 appendixes. The two editors and the 19 contributors all practice at Yale University School of Medicine in the department of anesthesiology and in other departments. The editors preface that this new edition of the Handbook “has been expanded to reflect contemporary pediatric anesthesia practice.” The book has been more completely cross-referenced to provide more information and avoid repetitions.

The first section is on perioperative general considerations. It consists of five chapters detailing from the preoperative evaluation to the emergency and recovery of the child. The chapters have been well written, in a concise, easy-to-understand format. Particularly excellent are the tables in the section on preoperative evaluation, especially those depicting common pediatric laboratory values. In the chapter on equipment and monitoring, the tables on modes of oxygen therapy are very useful because the information stated is thorough and hard to find in other “easy-access” textbooks. Also, more information has been included on the management of the difficult airway with a nice description of some of the airway “gadgets,” including the laryngeal mask airway (LMA) and the Bullard laryngoscope. Perhaps a separate small chapter on induction of anesthesia with a table on induction agents would have been good to have in this section.

The second section, comprised of 11 chapters, is titled “clinical management.” Each chapter is devoted to a particular organ system. One of the biggest assets of this handbook is the large amount of information (textbook-like) that has been included in this section in a concise, well-written manner. The authors should be commended for this. In particular, the chapters on pulmonary and congenital heart disease (CHD) are easy to follow and very thorough. The different pathophysiologic mechanisms in CHD are well explained, and the figures on the different operations for these children are very informative. They should be considered a must-read especially for nonpediatric practitioners.

The third section covers unique concerns in pediatric anesthesia in seven separate chapters. Old and current controversies in the field are well presented. A nice chapter on pediatric pain management is included. Unfortunately, not many pictures or figures were included in the description of peripheral nerve blocks. The chapter on ambulatory anesthesia has been rewritten to focus on unanticipated admissions. Ambulatory dilemmas, like the child with a runny nose and the age that “ex-preemies” are allowed for surgery and anesthesia are well covered in other areas of the handbook. The last chapter includes several tables on many pediatric syndromes and anesthetic implications. This will be very useful as a quick reference guide for practitioners.

Finally, the appendices cover an array of issues, including drug lists, pediatric resuscitation algorithms and drug dosages, excellent vascular access pictures, and the latest recommendations against bacterial endocarditis.

In summary, this is a well-written handbook with a vast amount of information. Every chapter is also well-referenced, including, in some cases, very recent publications. Many tables and figures make it easy to follow. Candidates about to take the anesthesiology boards should find it a welcome addition during their pediatric studies. The poetry and cartoons throughout the book are enjoyable and truly the work of talented artists. In regards to price, the value of the book clearly exceeds the stated price.

Hernando De Soto, M.D.

Associate Clinical Professor; Director of Pediatric Anesthesia; University of Florida Health Science Center, Jacksonville University Medical Center; Jacksonville, Florida

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