James C. Eisenach, M.D., Editor.

Image Guided Pain Management. Edited by P. S. Thomas. Philadelphia, Lippincott-Raven, 1996. Pages: 160. Price:$75.00.

The author had the right idea by attempting to produce a guide for interpreting the position of catheters and needles when using radiologic instrumentation for nerve blocks. The final product, however, falls short of its goal to some extent for a series of reasons.

First, the copy editing of the chapters failed to detect many significant typographic and syntax errors throughout the textbook. Second, the quality of many radiographs is so poor that it is difficult to identify the anatomy. Other pictures show trivial aspects of the block and should have been omitted or replaced with more images of needles or contrast near target structures. Most problems in image clarity are a result of overexposure of the picture compounded by further copying for publication. Third, the title is somewhat misleading as it implies that pain management is the topic. In actuality, the book deals with nerve blocks. Fourth, I believe that a cost of $75.00 is too high for the amount of information presented (almost 50 [cent] per page of text compared with Bonica's textbook at about 11 [cent] per page).

The book is divided into 21 chapters-19 of which deal with a particular type of block. The first two chapters describe the principles of radiologic technology and contrast media and are basic but useful as a synopsis. Most chapters are about six pages long (the book is only 6" x 9"). Thus the informational content is sketchy. I did not find many of the photos to be as helpful as I anticipated, and the same photo is used in consecutive chapters separated by only four pages. Other pictures such as a woman lying in the prone position with a pillow under her abdomen seems trivial and a waste of page space.

The strong chapters in the book deal with celiac plexus, hypogastric plexus, lumbar sympathetic, and glossopharyngeal nerve blocks. On the other hand, one chapter dealing with intraarticular facet blocks shows no images but pen and ink drawings of skeletal structures similar to a Labat text on regional anesthesia.

Overall, the book is somewhat disappointing and relatively expensive to recommend purchase. However, for those who spend the majority of their pain practice in a radiology suite, a perusal of this text may provide specific information on esoteric blocks that may improve their outcome success. Hopefully, the author and publishers will endeavor to use this critique to improve on a second edition because the concept of the book is a useful topic for interventional pain practitioners.

Mark J. Lema, M.D., Ph.D.

Chair of Anesthesiology and Pain Medicine; Roswell Park Cancer Institute; Associate Professor & Vice Chair of Anesthesiology; SUNY at Buffalo School of Medicine and Biomedical Sciences; Buffalo, New York 14263