Anaesthesia and Intensive Care A-Z: An Encyclopaedia of Principles and Practice, 4th Edition.  By Steven M. Yentis, B.Sc., M.B.B.S., F.R.C.A., M.D., M.A., Nicholas P. Hirsch, M.B.B.S., F.R.C.A., F.R.C.P., Gary B. Smith, B.M., F.R.C.A., F.R.C.P. Philadelphia, Churchill Livingstone, 2009. Pages: 584 (paperback). Price: $136.00.

This book was last revised in 2004. With several new and revised entries, this edition reflects ongoing advances in the fields of anesthesia and critical care. According to the preface, the authors initially created the book as a review for candidates taking the Royal College of Anesthetists' Fellowship examinations, which explains its format of short, high-yield entries.

Like the popular street atlas London A-Z , which covers every street, highway, major point of interest, park, school, and tube station in London, this book is comprehensive. It consists of hundreds of alphabetized entries ranging from the common to the obscure. Topics relevant to the practice of anesthesia and critical care include pharmacology, diseases, physiology, anatomy, and history. As the title suggests, the entries are arranged alphabetically, with extensive cross-references to ensure full coverage of topics and ready access to related information. The cross-references are numerous and are easily identified by bold print. The alphabetical arrangement makes up for the lack of an index. There are many tables, graphs, and figures in black and white and grayscale that are generally well done and useful. Some entries have a relevant reference generally from the last decade, which we favor, although these references supply only the journal and author information without the article's title. Having just completed Part I of the American Board of Anesthesiology certifying examination and the examination for Maintenance of Certification for Anesthesia, we put this book through the paces. Every topic that we could recall from the tests had an entry in the book.

The authors should be commended for the impressive breath of content, but some criticisms have to be discussed. Much of the difficulty we experienced with the book is a result of the differing British and American anesthesia certifying systems. Most of the principles remain the same regardless of geographic location, but the American Board of Anesthesiology examinations distinguish between anesthesia and critical care. In a 584-page book covering anesthesia and critical care, this breadth necessarily comes at the expense of depth of coverage. There is a palpable British influence throughout the text with entries such as “triservice apparatus, an anesthetic apparatus adopted by the British Armed Forces for battle use.” The entry on postoperative shivering lists pethidine and pentazocine as possible treatments, and the differences in units of measurements led to an entry recommending 8 mmol of magnesium sulfate for use in advanced cardiac life support. Although it is easy enough to remove the extra vowels in words like anaesthesia, most American anesthesia providers would not be familiar with those drugs or dosages. The British influence does have its advantages. There are many instances where A-Z's approach yields a slightly different emphasis or explanation that brings the American reader a new view of the topic.

The question is for whom and for what purpose is this book useful? The authors have produced clear, succinct text and helpful illustrations that provide high-yield information in a single volume. Its format and style are reminiscent of a handbook, but it is too bulky for that use. The lack of a thematic organization to the text, such as preoperative assessment, makes it difficult to recommend as an introductory text for anesthesia or critical care practitioners. The authors bill the book as a review for the British certifying examination, with which we have no experience. As a review book for the written examination for the American Board of Anesthesiology, the length is too long, its format too awkward, and it does not emphasize key study points. A good review book should alert the reader to especially important, commonly tested concepts, and it should delineate concepts as distinctive, most common, or most likely to occur. However, there is a niche for Anaesthesia and Intensive Care A-Z. We believe that this book may be most useful as an intraoperative reference, especially for trainees, or as a first-line reference to use while completing practice questions from another source. Its often fresh approach to familiar topics, presumably reflecting the differences in British training and practice, is useful especially in learning about difficult concepts. Finally, its unique format of highly cross-referenced entries, reminiscent of Internet text with embedded links, will appeal to many modern readers accustomed to this integrated content.

*University of California, San Francisco, San Francisco, California.