Handbook of Clinical Anesthesia. Edited by Paul Barash, M.D., Bruce Cullen, M.D., and Robert Stoelting, M.D. Philadelphia, Lippincott-Raven Publishers, 1996. Pages: 928. Price: $39.95.

The publication of Barash, Cullen, and Stoelting's third edition of the Handbook of Clinical Anesthesia prompted me to retrieve from retirement my own first edition that accompanied me during much of my residency in times past. As I page through my dog-eared old edition, the mark of those times is evident in the pages: a dried splotch of betadine still adheres to the pages where I baptized the section on axillary blockade, and the pages on inhalational anesthesia pharmacology still crinkle where long since evaporated drool once pooled when sleep overcame me. The mark that is most telling, though, is the way my first edition still holds its comfortable, curved contour earned through a certain intimacy with my left rear pants pocket.

Comparing new to old, I am first struck by the new cover color scheme of the third edition: hunter green, yellow ochre, and bright cerulean blue, which taken together are pleasingly very 1990s and very new-millennium. Inside the new edition, the authors strove to make the handbook a true companion of the textbook, Review of Clinical Anesthesia and of the CD-ROM, Lippincott-Raven Interactive Anesthesia Library by being as contemporary and as comprehensive as possible. They have made this edition more contemporary by adding an emphasis on the economics of health care delivery and practice management in anesthesiology. The third edition is certainly more comprehensive, containing almost twice the pages of the first edition with every chapter from the textbook represented in this handbook. Wisely, the publishers have used a thinner paper stock so that the additional pages do not result in a third edition that is double the weight and bulk of the first. Despite the thinner stock, the third edition is still noticeably heavier and bulkier.

The overall format of the handbook remains unchanged in its third edition. The first section contains synopses of the textbook's chapters that are readable and easily digested. The text flows in outline form, carried along by plentiful and sharp figures and tables. Here, the authors avoid controversy and literature references in favor of practical information that is fundamental. Basic principles, intraoperative management from a subspecialty and systems-oriented approach, and preoperative and postoperative management are addressed in these first 800 pages of the handbook. Well marked on the book's end pages, the second section of the handbook is made up of about 100 pages of appendices designed for quick reference. These appendices are common formulae, a drug information list, an atlas for ECG interpretation, the American Heart Association CPR guidelines, ASA standards, and difficult airway algorithms. The indexing of this edition seems notably improved, making the information compiled in both sections of the handbook that much more accessible.

The authors, in their preface, refer to the handbook as a "bridge to the scope of knowledge required for superior clinical care." They clearly do not intend the handbook to replace any of the more detailed or specialized reference texts that line our library shelves. Instead, the handbook presents the reader with a compilation of fundamental information organized in an easily portable, accessible format that provides companionship in the (sometimes messy) clinical arena, where learning is a constant, daily process.

J. C. Gerancher, M.D.

Assistant Professor

Department of Anesthesiology; Stanford University School of Medicine; Stanford University Hospital; Stanford, California 94305-5115