Edited by Wilton C. Levine, M.D., Rae M. Allain, M.D., Theodore A. Alston, M.D., Ph.D., Peter F. Dunn, M.D., Jean Kwo, M.D., Carl E. Rosow, M.D., Ph.D. Philadelphia, Lippincott, Williams & Wilkins, 2010. Pages: 728. Price: $49.95.

Clinical Anesthesia Procedures of the Massachusetts General Hospital, Eighth Edition  accomplishes its goals of emphasizing clinical fundamentals for perioperative anesthetic management. The handbook is well organized and caters to all levels of anesthesia providers, including medical students, residents, nurse anesthetists, and anesthesiologists. The book is intended to “augment experienced clinical teaching and inspire more detailed study.” Each chapter includes a robust list of suggested reading for further study.

The authors have preserved the overall organization of the book, which includes preoperative, intraoperative, and postoperative management issues. This approach makes information easily accessible, which is crucial while on call or in an emergency situation. The chapters are well written in an organized outline layout and supplemented with excellent tables and illustrations.

The preoperative sections cover a myriad of clinical topics and provide a brief overview of basic organ physiology. The chapter on cardiac disease offers a solid summary of the American College of Cardiology/American Heart Association guidelines, valvular disease pathophysiology and management, and perioperative pacemaker management. The intraoperative sections tackle multiple topics ranging from neuromuscular blockade monitoring to anesthesia outside of the operating room. Perhaps the most useful section is the one on intraoperative problems, which offers differentials for likely intraoperative complications. Every trainee should have this section memorized. The regional anesthesia chapter is an excellent resource for peripheral nerve block procedures. The perioperative section addresses issues including postanesthesia care unit, respiratory failure, pain management, and end-of-life issues.

This edition has undergone subtle updates and changes to make the text easier to read. Although the book maintains its pocket-size dimension, it is wider, which allows for a larger font. The book continues to refine and update information in our field as it changes. Many chapters have been rewritten and reorganized to convey critical information more clearly. More dramatic changes are seen in the chapter on transfusion therapy, including updates on estimating blood volume in obese patients, transfusion-related acute lung injury, graft versus  host disease, and the new data on the utility of aprotinin. Readers will find updated guidelines for Advanced Cardiac Life Support, endocarditis prophylaxis, central line placement (although the ultrasound-guided technique is not described), and hand hygiene. This edition describes practices such as laryngeal mask airway use for thyroidectomies, paravertebral blocks, vagal nerve stimulators for epilepsy, episcleral blocks, and anesthesia for percutaneous lung biopsy. New medications for hypertension and diabetes are discussed. Finally, the handbook stimulates the reader to pursue further study of ongoing debates such as oxygen and wound healing, utility of positive end-expiratory pressure, overall management of fluid, recommendations for blood transfusion, postoperative cognitive dysfunction, fluid management in burn patients, and acupuncture.

Overall, this is a fantastic pocket reference that ambitiously tackles most aspects of anesthesia care. The book continues to peripherally address complex topics for students with an existing understanding of our field. The updated reference list at the end of every chapter directs readers to more intense review of topics. The book underwent dramatic revisions from the sixth to the seventh edition. Although this new edition contains subtle changes from its previous form, the updates on guidelines and medications warrant its purchase. With the advent of smart phones and computer access in the operating room, the utility of this book may change. However, if cellular reception is poor, computer access is limited, time is limited, and I could have one handbook with me … it would be Clinical Anesthesia Procedures of the Massachusetts General Hospital, Eighth Edition .