Edited by Jerrold Lerman, M.D., F.R.C.P.C., F.A.N.Z.C.A., Charles J. Coté, M.D., David J. Steward, M.B., F.R.C.P.C. New York, Churchill Livingstone Elsevier, 2009. Pages: 544. Price: $73.95.

Although you cannot judge a book by its cover, but you can often foresee its usefulness by its size. Jerrold Lerman, Charles Coté, and David Steward provide an excellent operating room companion with the sixth edition of Manual of Pediatric Anesthesia . This book is a highly portable and thorough guide to everyday—and not-so-everyday—clinical challenges encountered when providing anesthetic and analgesic care for children.

The book begins with three chapters that discuss the anatomic and physiologic underpinnings of pediatric anesthesia. It provides an excellent review of the subject for individuals new to the field as well as experts who need to refresh their memories. Although the chapter dedicated to regional analgesic techniques provides a good anatomic and pharmacologic basis for techniques, it is, unfortunately, devoid of descriptions of ultrasound-guided techniques.

The sixth chapter focuses on medical conditions that are frequently encountered in a pediatric referral center setting and includes excellent evidence-based and experience-based guides to dealing with these problems. I was particularly pleased with the discussion of anesthetizing a child with an upper respiratory infection. The procedure as described in this book is more of an artistic technique than step-by-step “cookbook” formula.

Postoperative care and pain management is discussed in the seventh chapter, which includes useful quick reference guides to dosages parameters of commonly used analgesics.

The second section of the book is dedicated to anesthesia for specific operations and covers a wide gamut of commonly encountered surgeries. Neurosurgery, ophthalmology, otorhinolaryngology, dental procedures, orthopedics, urology, trauma, and plastics are all covered in good depth—allowing for quick perusal that is extremely suitable for trainees and midlevel providers, or the physician returning to the pediatric operating room after some time.

The authors dedicate chapter 13 to neonatal emergencies and commonly seen general and thoracoabdominal surgical cases with an equal depth. Chapter 14 is dedicated to cardiovascular procedures. Although the chapter includes an excellent discussion of cyanotic and noncyanotic congenital heart disease, I feel that diagrams of the processes described would have been helpful.

A quick discussion of anesthesia in remote locations focuses attention to the often hard-to-describe challenges encountered when caring for children in radiology suites and off-site locales.

The book finishes with three excellent appendices that address the anesthetic implications of syndromes and unusual disorders, cardiopulmonary and neonatal resuscitation, and drug dosing.

Overall, Manual of Pediatric Anesthesia  is a well-written and accessible guide. It provides a practical approach to referral-level cases and can be used at many levels of acuity, although it does pay particularly good attention to complex disease processes. The appendices also serve as an excellent quick-reference guide for rare syndromes. Potential additions to future editions could include references to ultrasound-guided pain procedures, as well as descriptions of rare metabolic disorders and their management.

The book is an excellent carry-along manual, much like the frequently seen Clinical Anesthesia Procedures of the Massachusetts General Hospital . It can also serve nicely as an introductory reference for newcomers to pediatric referral center anesthesia departments and refamiliarize those returning to the arena.

Health Sciences Center and The Children's Hospital, University of Colorado, Aurora, Colorado. alan.bielsky@ucdenver.edu