Edited by Gabriella Iohom, M.D. and George Shorten, M.D. Philadelphia, Lippincott Williams and Wilkins, 2010. Pages: 140. Price: $162.00.
Regional anesthesia is the hottest topic in anesthesiology. It is not surprising that Current Topics in Peripheral Nerve Blockade was chosen as the subject of the fall quarter edition of the International Anesthesiology Clinics. The editors included chapters on some of the “hot” topics in peripheral nerve block: the role of ultrasound; local anesthetic dose and volume used in ultrasound-guided techniques; perineural catheter techniques; and the management of local anesthetic toxicity. They are to be commended for also including topics that are just as important but perhaps not quite as “hot,” such as: developing a training program; simulation for training in ultrasound-guided peripheral nerve blockade; asepsis in regional anesthesia; acute compartment syndrome; and intraneural injection and peripheral nerve injury.
This is a small (140 pages), easily-read volume with 10 discreet chapters. Each chapter was written by recognized experts in their fields. Each of the chapters stands alone, making this a very easy read for the busy professional. On the other hand, as a multiauthored text, this volume does contain some repetition and inconsistency. These issues are minor nuisances, such as referring to ultrasound-guided regional anesthesia variably as UGRA, USGRA, and USgPNB. Similarly, having separate chapters on developing a training program, the role of ultrasound in regional anesthesia, and simulation for training in USgPNB leads to considerable repetition.
The chapter on developing a training program, written by Jyh Shen Tan, M.B.B.S., M.Med., Ki Jinn Chin, M.B.B.S., M.Med., F.A.N.Z.C.A., F.R.C.P.C., and Vincent W.S. Chan, M.D., F.R.C.P.S. (all from Toronto Western Hospital, Toronto, Ontario, Canada), is even-handed and extremely informative. As a division chief of regional anesthesiology and perioperative pain medicine, I found it to be the most concise but complete synthesis of this topic that I have encountered. I would strongly recommend this chapter to anyone participating in education in this field. The related chapter on simulation for training in ultrasound-guided peripheral nerve block provides an excellent overview of this very timely topic. Of particular interest is a table suggesting the desirable characteristics of the ideal simulator for this training. The chapter on asepsis is an excellent summary of the evidence on the subject and is a call to arms to improve compliance with basic aseptic techniques in our field. The authors for the chapters on local anesthetic dose and volume with ultrasound, nerve injury, perineural catheters, and local anesthetic toxicity provide a thorough review and balanced coverage of the topics. These chapters are well written. The chapter on regional anesthesia in acute compartment syndrome by Stephen Mannion, M.D., F.C.A.R.C.S.I., M.R.C.P.I. (Department of Anesthesiology, South Infirmary-Victoria University Hospital, Cork, Ireland) and Xavier Capdevila, Ph.D., M.D. (Professor, Department of Anesthesia and Intensive Care, Hôpital Lapeyronie, Montpelier, France) deserves particular praise. This is one of the best summaries of this topic to date. First they provide a good background on the pathophysiology of the phenomena and the current state of the art for diagnosis and treatment. They then provide a thorough review of the literature on the subject, followed by well supported recommendations. As I believe that a thorough understanding of this topic is essential for anyone who hopes to be considered a consultant in regional or orthopedic anesthesia, this chapter alone justifies the publication of this monograph. It will become required reading for our residents and fellows.
My only criticisms of this volume are minor in nature. One surprise was that the chapter on the “hot” topic, ultrasound, was only eight pages long and contained only one poor-quality ultrasound image. Much of this was a discussion of the future possibilities of three-dimensional and four-dimensional imaging. I believe the readership of this type of monograph would appreciate a more “current topics” approach to this area. The chapter on adjuvants in peripheral nerve blockade, although well done, seems a bit “old hat” for this type of volume and does not present any particularly new or practice-changing information.
In conclusion, Current Topics in Peripheral Nerve Blockade provides a useful, thought- provoking read for anyone interested in this area. Although it does not supplant the need for textbooks for broader coverage of this topic, I believe the editors met their stated goal of providing a well-written, informative, and thought-provoking monograph.