James C. Eisenach, M.D., Editor

Acute Pain Management: A Practical Guide. By Pamela E. Macintyre and L. Brian Ready. Philadelphia, W.B. Saunders, 1996. Pages: 198. Price:$14.95.

This easy-to-read paperback book can easily fit in lab coat pocket and is offered at a reasonable price. The authors are two leaders in the field of acute pain management. The book is aimed at nurses, medical students, and doctors in training to provide them with simple and practical guidelines for the management of acute pain problems. It clearly achieves this, because the format is clear and to the point. All practitioners should use this book as a quick reference to acute pain management. In addition, this book should be required reading for all anesthesiology residents rotating through the pain service.

This book could not have come at a better time. With the increase in managed care, the responsibility of acute pain management will fall into the hands of the nonpain specialist, and only after their efforts fail will the specialist be called on. The bulk of the techniques described in this book can be initiated by the nonpain specialist. If the pain specialist is required for pain control, this book gives a good overview of more advanced techniques used in pain management, such as epidural and intrathecal analgesia.

The first chapter gives an overview of the significance and assessment of acute pain, and the following chapters cover drug pharmacology and pain therapy techniques. The book is rounded off with a final chapter on education, which is becoming increasingly important. The strongest chapter is on opioid pharmacology, which is a primer that all healthcare providers should read. The section on opioid tolerance, dependence, and addiction clears some of the misconceptions associated with opioid use.

The authors present a couple of good treatment algorithms in the chapter on traditional methods of opioid administration, and it is unfortunate they did not use this format throughout the book. This is a very quick and effective means of conveying a treatment plan, and would have provided a consistent flavor to the book. Nonetheless, this is an excellent book that provides valuable information to healthcare providers of all levels for the treatment of acute pain.

Mark S. Wallace, MD; Assistant Clinical Professor, Department of Anesthesiology, University of California, San Diego, San Diego, California 92103.