Encyclopedia of Anesthesia Practice. By Steven M. Yentis, Nicholas P. Hirsch, and Gary Smith. Edited by Thomas Feeley. New York, Churchill Livingstone, 1996. Pages: 435. Cost:$80.00.

The Encyclopedia of Anesthesia was first published in 1993 in England. Originally designed for candidates taking the final portion of the examination for the Fellowship of the Royal College of Anaesthetists, the current text is a revision of the English edition intended for the U.S. market. The aim of the book is to provide information on physiology, pharmacology, anatomy, physics, statistics, history, clinical anesthesia, and intensive care to anesthesiologists. The text is written by three anesthesiologists and intensivists from the United Kingdom, and one from the United States. The authors are to be congratulated for providing up-to-date information for more than 1,800 entries covering a wide range of topics.

Following encyclopedia format, the text is divided into 26 chapters, with entries in alphabetical order. The authors have succeeded in writing concise entries, often in a list of “keywords” or a few paragraphs. This gives the reader a brief review of the topic. For example, the ABO blood groups are covered in one paragraph and a table, and analgesia in one sentence. Some entries contain a helpful up-to-date reference for further reading. However, the attempt to cover all of anesthesia and several related topics in one book results in entries that often are too brief (even cryptic) to include new learning. Or, an entry may refer to the unwanted effects of a medication, but, due to space constraints, not specify these effects.

Of some concern is the absence of certain common clinical procedures, such as axillary block. Of greater concern is the presence of recommendations relaying outdated (described as “now rarely used”)/or controversial information regarding clinical care. For example, reduction of labor pain using abdominal decompression by negative pressure is not common clinical practice. And, the use of particulate antacids such as magnesium trisilicate is now actively discouraged. In addition, there are errors, likely typographical, but, nonetheless, hazardous. The concentration of hypertonic saline solution is presented as 0.18% when it should be 1.8%, and the concentration of sodium is presented as 135–145 mEq when it should be 135–145 mEq/L.

Efforts to edit the British version of this text for the U.S. market are moderately successful, but the current text still contains a multitude of references, terms, and drugs relevant only to anesthetists in the U.K. For example, the maximum recommended intravenous dose for labetalol hydrochloride in the U.S. is 300 mg, but the text recommends 200 mg; yohimbine is approved in the U.S. for clinical use, although not anesthesia-related, and adhesive tape is preferred to “sticking plaster.”

Formatting of this new encyclopedia has both strengths and weaknesses. Each term defined is printed in boldface font to make it easy to find on the page. However, all terms cross-referenced to the definition also are printed in boldface, giving equal visual weight to the topic and the cross-referenced terms. When lists of keywords are used to define a term, the cross-referenced items unintentionally appear more important that other keywords. The use of a different font, such as italics, would have been more successful.

This text contains several well-done, clear, line drawings. For example, diagrams on the complex autonomic nervous system and brachial plexus have been simplified to clear, concise illustrations. The style of the drawings, as well as the text, is consistent throughout. However, the illustrations and tables sometimes do not appear on the same page as the entry, making a quick review of a topic inconvenient.

Despite these weaknesses, The Encyclopedia of Anesthesia fills an existing need for a (relatively) comprehensive reference text for anesthesia and anesthesia-related topics. Due to the brevity of the entries, it may serve as a general reference for anesthesiologists, but should be used with caution as a reference for clinical anesthesia and may be limited as a text book for anesthesia residents and medical students. However, the range of history-and surgery-related topics is much greater than that of other general anesthesia reference books. As a result, this encyclopedia may also be of interest to other health care workers (e.g., nurses, surgeons and hospital administrators), as well as other interested professionals (e.g., journalists, attorneys, and insurance companies).

Pekka Talke, M.D.

Department of Anesthesiology; University of California, San Francisco

521 Parnassus Avenue; San Francisco, California 94143–0648