Edited by James E. Cottrell, M.D., F.R.C.A., William L. Young, M.D. Philadelphia, Mosby Elsevier, 2010. Pages: 480. Price: $199.00.

Neuroanesthesia and perioperative care of the neurosurgical patient requires a thorough knowledge of anatomy, physiology, and pharmacology—in addition to familiarity with the surgical procedure, neuroimaging, and disease-specific pathophysiology. Integration and clinical application of this knowledge is essential to formulate an intelligent treatment plan as well as to predict, prevent, and manage potential complications.

The fifth edition of Cottrell and Young's Neuroanesthesia  comprehensively yet succinctly discusses the clinical aspects of neuroanesthesia as well as the science behind it. The chapter format, along with strategic use of tables, figures, and images, has resulted in a resource that is both visually inviting and helpful in facilitating knowledge retention. Each hardcover text is also accompanied by full online resource access.

This newly released text has been substantially revised and updated from the 2001 edition. These many changes include William L. Young, M.D., as coeditor and 23 new authors. These additions provide fresh insight and expertise from a diversity of backgrounds, including basic and clinical scientists, neurointensivists, radiologists, neurosurgeons, and neuroanesthetists. The diversity of authors provides a well-balanced perspective to this text.

The authors did an excellent job providing an up-to-date and comprehensive discussion of each topic without excessive detail that obscures salient points. Key studies that have helped shape clinical care are highlighted throughout and have been updated since the previous edition. Most chapters can be read easily in a single sitting, allowing easy assimilation of the information presented and placement within the broader clinical context.

The breadth of the text is also appropriate, with attention given to all major clinical categories as well as a complement of supplementary chapters devoted to topics such as neuroradiology and neurophysiologic monitoring. In total, the fifth edition has 25 chapters, seven of which have been added since the 2001 edition. These include: “Pediatric Neuroanesthesia and Critical Care,”“Awake Craniotomy, Epilepsy, Minimally Invasive, and Robotic Surgery,” and “Anesthesia for Neurosurgery in the Pregnant Patient.”

In summary, Cottrell and Young's Neuroanesthesia  not only provides expert discussion concerning the foundational “pieces” of neuroanesthesia, it also helps with the integration and clinical application of these pieces. Although suitable and recommended for anesthesia trainees, this text goes far beyond any clinical handbook or board-preparation type resource. As Michael Todd, M.D., says in the Forward of this edition, this is a book for professionals.

It is for those who want to provide the highest level of care for their patients by truly understanding why they do what they do. This approach to neuroanesthesia will allow one to adapt and handle any clinical situation that arises in a confident and intelligent fashion.

Overall, this is an improved and updated version of an already successful neuroanesthesia text that has been around for many years. Although not without the occasional minor error inherent to all texts of this size, the editors have again produced a comprehensive and up-to-date resource that can be read cover to cover.

In conclusion, I would recommend Cottrell and Young's Neuroanesthesia  to resident trainees and to experienced clinicians who desire to update their knowledge and better understand the principles that guide their clinical actions. There are a number of textbooks of neuroanesthesia, each with a slightly different focus and each with a different breadth and depth. Of those, Cottrell and Young's Neuroanesthesia  deserves the top shelf on the bookshelves of academic and clinical departments, as well as those of practitioners who desire the ready availability of a resource on the current state of the art of the practice of neuroanesthesia.

University of California–San Diego, San Diego, California. blemkuil@ucsd.edu