Anesthesiology. By David E. Longnecker, M.D., David L. Brown, M.D., Mark Newman, M.D., and Warren Zapol, M.D. New York, McGraw-Hill, 2008. Pages: 2,278. Price: $249.00.
There is a new kid on the block in the neighborhood of comprehensive anesthesia textbooks, Anesthesiology by David Longnecker et al. It is a daunting task to create a new comprehensive anesthesia textbook when established books already exist. It is impossible to avoid being compared to Miller’s Anesthesia 1and Clinical Anesthesia by Barash.2In this regard, Anesthesiology proves to be a reasonable alternative to these other texts.
The text is a single-volume book with an accompanying CD. The large size of the single volume requires a sturdy surface for reading, but it prevents the annoying task of indexing two volumes for a specific topic. The CD is primarily an image bank that is very user-friendly and allows the easy import of images into presentations.
The content is organized into nine parts that are identified by color-coded page edges that makes it easy to quickly find the section of interest. There are key points highlighted at the beginning of each chapter as well as extensive charts and tables to summarize important concepts. Part 1 is the expected history overview and the future of our specialty. Part 2 is a 20-chapter in-depth exploration of the challenges specific patient populations present in the preoperative evaluation. This is a welcome departure from the more limited overview of preoperative period some texts provide.
Part 3 addresses safety and risk reduction, including issues such as positioning and electrical safety. Part 4 comprises the majority of the text and covers the management of anesthesia. It includes chapters on monitoring, airway, pharmacology, regional anesthesia, and specialty areas of anesthesia. This part could have been broken down into smaller parts to make the color-coded page index more useful. Part 5 discusses the postoperative arena.
Part 6 addresses critically ill patients and has chapters that look at the many roles that anesthesiologists perform in the care of this difficult patient population. It includes pathophysiology, ventilation, and overall care of trauma, burn, and other critically ill patients. There is even a chapter dedicated to the transport of critically ill patients, which has become a frequent activity of many practitioners. Part 7 is labeled Special Considerations and reviews the broad topics of blood therapy, cognitive dysfunction, central nervous system protection, anaphylaxis, malignant hyperthermia, and thermoregulation.
Part 8 elucidates the nuances and challenges of caring for patients with chronic pain. In addition to medical management of chronic pain, interventional procedures are covered. Finally, part 9 discusses practice related issues such as legal, economic, and substance abuse.
Echocardiography is an essential tool in cardiac anesthesia, and its usefulness in noncardiac patients continues to expand. Recognition of echocardiography’s broad utility has emphasized the power of this clinical tool. This text provides a good introduction to transesophageal echocardiography, but primarily limits the discussion to cardiac anesthesia.
Whereas most current texts discuss the pharmacology of intravenous agents, this text is unique in its dedication of entire chapter (chapter 42) to total intravenous anesthesia. This is a refreshing recognition of the utility and potential advantages of total intravenous anesthesia. This chapter discusses techniques and drug combinations in addition to total intravenous anesthesia–specific concerns such as drug interactions, context sensitivity, and target-controlled infusion.
This text is a good compromise between the vastness of Miller’s Anesthesia 1and the clinical focus of Barash’s Clinical Anesthesia .2 Anesthesiology does an excellent job of covering all the pertinent topics in an organized manner. Like the other comprehensive texts, it is unlikely to be read cover to cover, but provides a superb clinical reference for residents and practicing anesthesiologists.
Any new textbook in field with well-established texts faces an uphill battle, but with its unique organization and clinical focus, Anesthesiology will create many satisfied customers.
University of Utah School of Medicine, Salt Lake City, Utah.