Pediatric Anesthesiology Review: Clinical Cases for Self-Assessment. By Robert S. Holzman, M.D., Thomas J. Mancuso, M.D., Navil F. Sethna, M.D., James A. diNardo, M.D. New York, Springer, 2010. Pages: 617. Price: $89.95.
New developments and novel surgical procedures in the pediatric population continue to expand the science and art of pediatric anesthesia. Pediatric Anesthesiology Review is a paperback review book that reflects the didactic series and curriculum developed to illustrate the comprehensive practice of pediatric anesthesiology at Children's Hospital, Boston, to which the four authors belong. Their contributions reflect their cutting-edge practice, teaching experiences, and interactions with fellows and faculty. The authors' labor of love has accomplished the formidable task of producing an essential review that is singular in its purpose of providing a means of understanding that befits a consultant rather than merely providing a deluge of information. The book should be warmly welcomed in the anesthesiology community, especially by pediatric anesthesiology fellows and junior consultants who are seeking creative ways to dialogue with the patient's family, discuss with colleagues, and refine their perioperative management skills.
The book is divided into two sections. The first covers the subject of pediatric medicine for pediatric anesthesiologists. This section is intended to bolster the clinical knowledge base and presupposes a basic understanding of pediatric medicine. It is essentially a set of multiple-choice questions covering seven topics, ranging from newborn medicine to general pediatrics. The questions are broad-based and unambiguous and address clinical situations pediatric anesthesiologists are likely to encounter in their practice. The questions are k type, which are more challenging than simple true/false questions or questions with single answers. However, there are plenty of questions that cover a wide range of topics, including physiology, disease processes, surgical procedures, postanesthesia care unit, and even critical care. The answers are conveniently located on the adjacent page. The explanations are clear but are not intended to provide detailed explanations, although a wealth of information has been packaged in a smoothly readable form. This section is not comprehensive in that it does not cover the complete spectrum of disease processes but is instead a sampling of “must-know ” topics. Furthermore, there are no references for additional reading in the written question section.
The second section, entitled ”Consultations in Pediatric Anesthesia,” is what brings flavor and uniqueness to this book. This section consists of 32 chapters in 465 pages and is devoted to a potpourri of topics ranging from prematurity and neonatal emergencies to organ-based chapters related to the respiratory, cardiac, renal, gastrointestinal, and connective tissue systems. Pediatric anesthesiology practice in neurology, ophthalmology, otolaryngology, burns, and orthopedic operating rooms as well as outside the operating room, neuromuscular disease, endocrinology, trauma, and transplantation reflect the broad range of topics covered. Each chapter begins with a clinical vignette that has been designed to not only measure knowledge but also assess the clinician's reasoning skills in performing tasks necessary to diagnose and care for the patient. The chapters are well organized into preoperative evaluation and intraoperative and postoperative courses. The cardiac chapter is divided into two sections, with the first describing a patient with tetralogy of Fallot who has a Blalock-Tausig shunt and who is scheduled to undergo a definitive repair. The second section discusses Glenn shunt and Fontan repair in a 4-yr-old boy with a double inlet left ventricle. The information is provided in a succinct and interesting manner that will certainly facilitate the trainee's grasp of the underlying concepts and motivate him/her to explore further. The case-based approach provides an interesting way for anesthesiology trainees to collaborate with faculty, enhance their oral presentation skills, and prepare for challenging clinical scenarios by explaining different management strategies and why particular data are valuable in formulating an anesthesia care plan. The book is, however, unusually devoid of illustrations and figures, and it would have been helpful if there were more diagrams and management algorithms.
As a review book, the authors have accomplished their purpose in a simple format with useful nuggets of information while avoiding the embellishments of a textbook. There is no question that this book would be immensely helpful to aspiring pediatric anesthesiologists with time constraints who need a quick and ready review or are planning to augment their learning curves. Although the book has two chapters covering regional and pain anesthesia, it is not possible to cover all aspects of pediatric anesthesiology in a handbook. The paragraph discussions are limited, but the book does not make any pretense to be comprehensive. The strengths include a different and creative approach to use imagination and a basic fund of knowledge to simulate situations in real-time operating room management. The book aims to provide a practical approach to achieve expertise and confidence that would serve to establish the reader's role as consultant in pediatric anesthesiology.
Children's Memorial Hospital, Chicago, Illinois. imukherji@childrensmemorial.org
