Bonica's Management of Pain.  By John D. Loeser, M.D. Lippincott Williams & Wilkins, Philadelphia, 2001. Pages: 2,178. Price: $299.00 new or $162.50 used from an on-line bookstore.

Many years ago, when I was a fellow in the Department of Anesthesiology and Critical Care Medicine, I searched the library to find the best resource to learn about the field of pain management. At that time, I found two books: Prithvi Raj's, “Practical Management of Pain”  1and, of course, John Bonica's, “The Management of Pain .”2Bonica's two-volume edition provided a wealth of information that was not easily found from other sources. The basic pathophysiology, the differential diagnosis, technological techniques, and a few of the neurosurgical techniques were nicely covered in this edition. I can't say that I ever got to the point of reading this two-volume edition cover-to-cover. Whenever an issue arose that required an in-depth review, however, I turned to Bonica's The Management of Pain . Unfortunately, this meant that I lugged two volumes of this text back and forth on a daily basis, giving myself acute back pain in the process. This book, which was the second edition, had been updated in 1990 from the first edition, which was published in 1953. It truly was amazing how thorough this book was for the clinician.

Ten yr have gone by, however, since the second edition was published, and this decade has seen a veritable explosion of information on the basic science of pain, techniques associated with appropriate pain therapy, and methods to control acute and chronic pain. Hence, I purchased John Loeser's 2001 edition of Bonica's Management of Pain  with great enthusiasm. This latest edition has the benefit of being the first published in a single volume. It maintains the strong, critical foundation contained in the earlier editions and is updated with current information and references to the literature. If I had to point to one area that could have been developed more in this text, it would be the role of interventional therapies for chronic nonmalignant pain. Spinal cord stimulation, intrathecal infusion therapy, and spinal injection techniques have become the mainstay of interventional pain management. These techniques, while covered, are not addressed in the same depth that is applied to considerations of medically- or psychologically-oriented approaches for pain.

John Loeser needs to be commended, however. He has accomplished the almost impossible task of updating John Bonica's thorough and expansive text on the management of pain while simultaneously producing a single-volume edition. Nothing was lost in this new edition and much has been gained.

Practical Management of Pain, 2ndedition: Edited by Raj PP. St. Louis, Mosby Year Book 1992
The Management of Pain, 2ndedition: Edited by Bonica JJ. Philadelphia, Lea & Febiger 1990