Miller's Anesthesia, Volumes 1 and 2, 7th Edition.  By Ronald D. Miller, M.D. (Editor), Lars I. Eriksson, M.D., Ph.D., Lee A. Fleisher, M.D., Jeanine P. Wiener-Kronish, M.D., and William L. Young, M.D. (Associate Editors). Philadelphia, Churchill Livingstone, 2009. Pages: 3,084 (volumes 1 and 2 combined). Price: $429.00.

For over a quarter of a century, Miller's Anesthesia  has been considered the pillar of anesthesia texts. The hallmark of this book is the presentation of concepts in a crisp and clinically useful manner. The editors have standardized each chapter with key points mentioned up front, followed by text that is enhanced by illustrations and tables. Each chapter concludes with a summary of key references. The content is easy to read with a rapid flow of pertinent information. A unique feature of this book is the online access to all Medline abstracts, full-text review articles associated with each topic, and a downloadable video library featuring full-length presentations of anesthesia procedures, including airway and ultrasound-guided regional anesthesia techniques.

The book consists of 102 chapters, including 13 that are new, and it is divided into nine sections. The color coding of different sections of the book and the 1,500 newly colored illustrations, diagrams, and tables allow readers to access unique topics readily and improve the aesthetic quality of the book. Topics such as International Scope and Practice of Anesthesia discuss the way anesthesia is practiced around the world to give this book a huge international appeal. The current hot subjects of sleep memory and consciousness and postoperative cognitive dysfunction have been added as new chapters. The chapters on respiratory physiology, preoperative evaluation, cardiovascular and respiratory monitoring, airway management, anesthesia for thoracic and cardiac surgery, orthopedic surgery, postanesthesia care unit, pediatric intensive care unit, treatment of chronic pain, and medical informatics have been written by new authors and updated with current literature.

As an example, because ultrasound application is becoming a common adjunct for regional anesthesia techniques, a new chapter on ultrasound guidance for regional anesthetics and accompanying online video presentations is particularly useful. Throughout the book, didactic text is complemented by an abundance of instructional material that seems to have been selected with care and relevance to the teaching of the pertinent material.

The Critical Care section has received a complete makeover with the addition of six new chapters. Four of these new chapters are noteworthy. Nitric Oxide has a good discussion regarding the use of this remarkable compound in pediatric and adult populations. The Critical Care Protocols section highlights discussions on the rationale for standardizing treatment and the use of evidence-based medicine. Neurologic Critical Care includes an interesting presentation on the management of traumatic brain injury and its long-term socioeconomic impact. The Renal Replacement Therapies section has particularly good presentations on the physiology of dialysis and the different replacement strategies that can be used in an intensive care unit.

Although there are a number of excellent new chapters, I would like to highlight several that are particularly good.

  1. Prehospital Emergency and Trauma Care: This chapter discusses the roles of anesthesiologists in creating modern critical care medicine, promoting the use of medical simulation in teaching, leading the training of prehospital emergency medical services, and dealing with mass casualties of war and austere conditions.

  2. Anesthetic Management of Cardiac Arrhythmias: an excellent addition because many more patients now require cardiac devices and procedures such as radiofrequency ablation for treatment of arrthymias than they did contemporary with previous editions of the text. The Transesophageal Echocardiogram section has superb diagrams and colored images presenting anatomy and pathology issues.

  3. Anesthetic Management for Bariatric Surgery: This chapter is well written and particularly useful because approximately 200 million people in the United States are significantly overweight or obese.

Chapters on patient positioning and principles of monitoring have great new diagrams, graphs, and tables. A chapter on information technology, use of computers in medicine, electronic medical records, computerized physician order entry, and telemedicine add helpful information.

This book is an excellent overview of the extant evidence-based, best-practice data available on all aspects of anesthesia. The editors are recognized international experts in the field and have, in conjunction with a superb and equally renowned group of contributors, produced a singular tome. The content, organization, prose, and numerous relevant illustrations make it an excellent text. I thoroughly enjoyed it and highly recommend it. The content is exceptionally well written, thorough, and well referenced. The editors and authors are to be congratulated once again for continuing their outstanding service to those of us who practice this wonderful specialty.

Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma.