Adult Perioperative Anesthesia: The Requisites. Edited by Daniel J. Cole, M.D., and Michelle Schlunt, M.D. Philadelphia, Elsevier Mosby, 2004. Pages: 460. Price: $79.95.

Adult Perioperative Anesthesia  is another volume in the Requisites of Anesthesiology  series, edited by Roberta Hines. This volume is edited by Daniel Cole, M.D. (Assistant Professor, Department of Anesthesiology, Mayo Clinic, Scottsdale, Arizona), and Michelle Schlunt, M.D. (Assistant Professor, Department of Anesthesiology, Loma Linda School of Medicine, Linda Loma, California). The hardcover text contains 30 chapters written by 37 contributors from diverse institutions. The preface indicates that it is intended for residents and practitioners who are preparing for an examination or wish to review a clinical case. These books are not intended to be the definitive texts on the various subjects. I have not read the other books in the series. Adult Perioperative Anesthesia  is intended to cover those areas of anesthetic practice not addressed in the previous volumes. The first seven volumes discuss pediatric, cardiac and vascular, regional, ambulatory, and obstetric and gynecologic anesthesia; critical care; and pain medicine. This volume consists of three sections: General Considerations, Anesthetic Management, and Special Considerations.

The most extensive (and helpful, in my opinion) chapter in part I, General Considerations, is “Preoperative Evaluation and Testing.” At 80 pages, it is almost as large as the other eight chapters of part I combined. I found the section on cardiac evaluation to be particularly helpful. The other chapters in this section are too abbreviated or simplistic to be helpful to most practitioners—either trainees or veterans. As an example, the chapter on positioning is only five pages of text, with no mention of postoperative blindness.

Part II, Anesthetic Management, has 11 chapters on specific surgical areas such as thoracic, transplantation, and orthopedic surgery. In general, these chapters are brief and helpful reviews. However, not all are as advertised. The chapter “Anesthesia for Hepatobiliary Surgery” is really not about anesthesia for surgery on the liver—it is about anesthesia for patients with liver disease. There is no discussion of hepatic resection.

Part III is titled Special Considerations and has 10 chapters on diverse subjects that pose special problems such as obesity, malignant hyperthermia, and allergic reactions. An unusual chapter is “Guidelines and Practice Parameters.” It is just what it says it is. It is almost entirely comprised of 22 boxes that reproduce documents that are readily available from American Society of Anesthesiologists, American Society of Regional Anesthesia and Pain Medicine, and two other organizations’ Web sites. The chapter lists the Web site addresses. Some may find this compilation convenient, but I think the average computer-savvy anesthesiologist would easily find this information without help.

Throughout the book, there is unnecessary duplication of information, which dilutes its significance. Chapter 1 has six pages devoted to the preoperative evaluation of pulmonary patients, and chapter 10 has four pages on the same subject. An identical figure depicting spirometry appears in both chapters on both page 51 and page 229. The chapter on monitoring has two boxes containing standards for intraoperative monitoring and standards for postanesthesia care units. They are virtually identical to the standards in the previously mentioned chapter on guidelines.

The boxes and figures are informative but unfortunately are poorly placed, making the information difficult to find. For example, excellent summary information about antihypertensives is placed in the section on pulmonary evaluation in chapter 1. There is an excellent explanation of the process of pulse oximetry measurement in the chapter on monitoring. The last sentence in one of the paragraphs references box 4-6, but this box lists the advantages of pulse oximetry and has nothing to do with anything on that page. Further, there are examples of long-discarded approaches such as a domed pressure transducer in figure 4-1 and a description of inserting a central venous pressure catheter through a 14-gauge needle (neither have been used for decades). There are annoying errors such as the Frank-Starling mechanism being called a principal  rather than a principle .

I would not purchase Adult Perioperative Anesthesia  for my library. This book contains much valuable information, but this information is readily available elsewhere in a more concise and readable format.

Ochsner Clinic Foundation, New Orleans, Louisiana.