By James Duke, M.D., M.B.A. Philadelphia, Mosby Elsevier, 2010. Pages: 574. Price: $49.95.

As our specialty of anesthesiology has grown, the spectrum of topics and concepts vital to its knowledge and practice has expanded dramatically. Mastery of this explosion of information available can be overwhelming not only for the novice anesthesia provider but also for the more experienced provider seeking a quick review of a targeted topic. The fourth edition of Anesthesia Secrets  by James Duke is a portable handbook of the Secrets Series® that could be useful to all levels of interest and practice in anesthesiology, including medical students, residents, attending anesthesiologists, and certified registered nurse anesthetists. It is a concise presentation of a multitude of topics, relevant and mandatory for anesthesia practice, that makes a worthwhile reference and review, that can be quickly accessible and on hand in the operating room, the preanesthesia clinic, the pain management clinic, and the intensive care unit.

James Duke has included numerous contributors, from anesthesia residents and clinical instructors to assistant professors, associate professors, and Professors of Anesthesiology, as authors of chapters for Anesthesia Secrets, Fourth Edition . This broad base of contributors, mostly from the University of Colorado, has produced an extremely well written, thorough, up-to-date, yet concise soft cover handbook.

The Top 100 Secrets are found at the beginning of the book and summarize vital concepts, principles, and details regarding the practice of anesthesiology. This makes an excellent, efficient framework upon which to organize anesthesiology board review and study as it allows a quick glance at the most frequently encountered board exam questions. After the Top 100 Secrets, the handbook is organized into 10 major sections that review the practice of anesthesiology, including basics of patient management and physiology, pharmacology, preparing to practice anesthesia, patient monitoring and procedures, perioperative problems, anesthesia and systemic disease, special anesthetic considerations, regional anesthesia, and anesthetic considerations for specific surgical procedures and pain management.

Each chapter is organized and the information is presented primarily in a question-and-answer format, which is helpful for board review and practice. The answers to the questions provide adequate depth of information yet are to the point, with bulleted text to separate longer, multifaceted answers and provide the information necessary for learning and supplementation of knowledge. Tables are included in some chapters, which further assist in the organization and concise presentation of details. Key Points boxes are shaded areas interposed among the questions and answers, serving to remind the reader briefly of the salient points and highlights. In addition, at the end of each chapter, suggested references, readings lists, and Web site addresses are provided that encourage the reader to seek more in-depth information from experts in the subject matter.

Anesthesia residents and academic attending anesthesiologists have found this handbook to be a guide and springboard from which to design and develop intraoperative teaching and educational discussions as well as board review series. Medical students have found that Anesthesia Secrets , Fourth Edition  provides them with a framework upon which to build an understanding of many of the basics of anesthesia during a short rotation in addition from reading large textbooks. Others with more in-depth experience in the specialty of anesthesiology have found Anesthesia Secrets, Fourth Edition  to provide a helpful review for the Maintenance of Certification in Anesthesia exam as the handbook is portable and filled with pertinent information.

Regardless of the reader's motivation, Anesthesia Secrets, Fourth Edition , continues to meet the editor's goal of providing a concise presentation of a wide range of topics important to anesthesia practitioners of all levels.

University of Virginia Health System, Charlottesville, Virginia.