I was truly excited when given the opportunity to review Clinical Anesthesia, 8th edition. As a program director and die-hard educator, I like to take the opportunity to review the resources available to my learners to make informed recommendations, plus I was due for an upgrade of my reference library!

At 1,702 pages plus appendices, references, and online content, Clinical Anesthesia, 8th edition, is a substantial body of work. Because I am a slow reader, it has taken me quite some time to work through it and render an opinion. Over the period of my review, I have used this text for primary reading on topics in clinical and basic sciences, referencing for question writing, developing curricular outlines, and preparing talks and enduring educational materials. I have found the text well suited for all those purposes.

Contributors and Goals

The editors and authors of this text are all distinguished experts within our specialty. Many have written texts and definitive reviews in their own right. It is the kind of “all-star” lineup that I would find a compelling draw at any conference or meeting.

The book’s dedication reads simply, “For all students of anesthesiology.” It is a goal that is kept in mind throughout the text, by making the material at once accessible and comprehensive, a difficult challenge to achieve.

The Preface discusses the progression of this text over time and how it integrates technology into its fabric as a core element of this series of textbooks. Indeed, I previously reviewed Clinical Anesthesia Fundamentals and can see the consistency of editorial approach throughout the series. Drs. Ortega and Sharar, both editors of the Fundamentals book, also serve as editors of this edition of Clinical Anesthesia; I believe that aids in maintaining the feel and formatting between the companion titles. It seems that this also may have aided in reducing redundancy of content between the titles. For example, the Fundamentals book has chapters on anatomy and physiology of the liver and kidneys, which do not reappear in this text.

This edition incorporates hundreds of new clinical vignettes and new videos, which will be discussed later. The companion handbook will no longer be available, but Dr. Holt from that editorial team brought her expertise to the flagship title, rounding out the editorial team and enhancing the expanded Clinical Updates in the text.

Structure and Layout of Physical Text

The physical text is laid out in 10 sections, color-coded on the top of the pages for easy localization within the book. Basic sciences constitute one third of the text, with clinical sciences constituting the remainder. This is a similar ratio to the Fundamentals title in the series. The editors selected contrasting colors to easily distinguish from adjacent colors, even for color-blind readers such as myself; for this I am grateful. It would be nice if the color band went a little further down each page, as it is slightly difficult to see without rotating the book toward oneself, but this is a minor quibble, particularly as I predominantly used (and most readers likely will use) the online version.

Each chapter begins with a list of the topics covered under the title. The text contains helpful callouts for videos (camera icon) and interactive vignettes (class or small group of people icon) as well as numbered key points. These key points are listed at the beginning of each chapter and then called out in the text where they occur for easy identification.

This approach is valuable for more active learning as it reminds learners when something important is happening. I found myself referring back to the list of key points with many of these callouts to refresh my memory on what the most important things were, making the process more engaging. There are many pictures and figures within the text and even more supplemental material online, so I rapidly switched over to that reading approach.

Online Platform and Features

This text comes with access to an online version through the VitalSource platform (VitalSource Technologies LLC, USA). The platform allows for highlighting, note taking, and flashcard creation, all helpful to enhance more active reading for knowledge acquisition. There is even a new feature in beta testing that will read the text aloud. Although the voice is far from natural, it is a nice option to access and should only improve with time. The text is fully searchable, and the index is hyperlinked to the chapters for easy navigation. The multimedia content is both embedded in each chapter and culled into a separate section for those seeking that content specifically. A “bookshelf” can be downloaded to your devices to allow for offline use of the book as well. The book downloads alarmingly quickly and works well in offline mode with the exception of the multimedia content, which requires an internet connection to stream. It does require Adobe Flash (Adobe Systems Inc., USA) for some of the video content and the download of an Adobe product to use the bookshelf feature and view the book offline on a laptop or desktop computer. I suspended my longstanding feud with Adobe to get access to these features and was pleased that they worked well. I also downloaded the bookshelf for my iPhone (Apple Inc., USA). Comments I read online had expressed frustration and Adobe incompatibility issues on Apple phones and tablets, but that was not an issue in my testing. Either I already have an Adobe application on my phone or they have engineered some work-around, but I had no trouble streaming the videos as long as I had a solid internet connection. I was initially disappointed that this book was not on the Inkling platform (Inkling, USA), which I had grown comfortable with while using Clinical Anesthesia Fundamentals in the past, but the VitalSource platform proved equally capable and easy to use. It seems like all of the new editions of Clinical Anesthesia series titles and a host of other anesthesiology textbooks have migrated there. My only other minor issue with the formatting of the online book is that the list of topics at the beginning of each chapter is not linked to the text for immediate access. However, as noted earlier, this can be done from the main index. This book also does not have the questions or quiz functionality that the Fundamentals title had, something I am hoping will be added to future additions. That said, it is a very well-appointed and easy-to-use book in both paper and electronic versions.

Content and Editorial Style

Chapters run from 16 to 40 pages in length, averaging roughly 25 pages. This is a manageable length and allows for a fair treatment of most content without getting lost in details. The book remains comprehensive without being overwhelming, which is a tough balance to strike. The editorial style remains true to the tradition of the series (i.e., concise, clear, and direct). It is a style that keeps a textbook readable and manageable for novices and experienced clinicians alike. This style is maintained throughout the text and is a testament to the attentiveness of the editorial team. There is an augmented section on wellness that is also a welcome addition. As an echocardiographer, I was extremely impressed with the range of echocardiographic resources included in this title. An authoritative chapter by noted experts is amply supplemented by online video content and an online atlas of ultrasound and echocardiography. This kind of complementary and supplementary approach allows the learner to explore topics in depth and get an excellent introduction to even the most complex topics.


In our specialty, there are several resources that have stood the test of time; Clinical Anesthesia is one of these. It is the textbook I used first in my training and maintains the editorial style I remain most familiar with for a definitive textbook of our specialty. When I first read this text as a resident, I could almost hear Dr. Barash speaking to me through the pages. Particularly in the clinical chapters, I felt him providing clear guidance and sage advice to help me learn well when I was about to do a case for the first time. It is the same style I have heard him use in lectures, Problem-Based Learning Discussions (PBLDs), and one-on-one interactions. It is a style that I responded to well. That voice is still strongly present and complemented well by those of the other editors and authors who have taken the same “no fuss” direct approach to helping students master our craft. It is nice to see this text continue to evolve with the addition of clinical cases and a tremendous amount of online content. It remains for me a central reference for all of my activities as clinician, educator, examiner, and student.