James C. Eisenach, M.D., Editor

Regional Anesthesia, CD-ROM, An Interactive Atlas of Anatomy and Techniques. By Marc B. Hahn, Patrick M. McQuillan, George J. Sheplock. St. Louis, Mosby-Year Book, Inc., 1998. Price:$199.95.

Regional anesthesia should be particularly well suited for multimedia teaching because visual knowledge of anatomy and manual techniques are essential basics as well as theoretical considerations. This CD-ROM is based on the book with the same title, but has a lot of additional features and tools.

The first two chapters provide general descriptions of pharmacology and regional anesthetic techniques. The next 39 chapters discuss the body from head to toe; each chapter is based on a specific anatomic location. The screen is presented with two windows, one for text and one for figures. On the margins of the screen are tools to navigate within the chapter and between the chapters. The figures may be photographs of intact skin, skin with deeper anatomic structures projected, or cadaver preparations and transverse sections from cadavers. All photographs may be zoomed and moved; some may be manipulated with different layers. Some figures are short films that may be played and manipulated as a video. The text may be explanations of numbered structures in the figures, descriptions of anatomy, anesthetic techniques, indications, or complications. Each section also provides a list of literature, which may be updated using an Internet link. One may also jump to key word search from anywhere in the program, combine different parts of the program, create personalized notes, and make a slide how of selected figures from the program.

The contents of this CD-ROM are quite brilliant and comprehensive. Many different ways of visualization are presented, and the text is easy to read, with a straightforward and practical style. My main criticism regards the layout and the user-friendliness of the program. The program only fills about one third of the screen, which makes it hard to see details, even with the zoom function. The colors are greyish, and some stronger colors would have been useful to illustrate important structures. The navigation tools are not self-instructive: one needs approximately 20-30 min with the very tiny manual to learn and practice before the program can be used. The program may be run directly from the CD, but then access to chapters 1 and 2, as well as some other features, is lost. A full installation is somewhat cumbersome because four other program items must be installed first. Although these are included on the CD, the instructions in the booklet or quick start card are not fully accurate and caused some trouble for this fairly average computer user. However, once these obstacles are conquered it is a very nice tool, both for education and self-instruction within regional anesthesia. In particular, the search function is very powerful and compensates for the lack of a clear index and menu-based structure.

Johan C. Raeder, M.D., Ph.D.

Professor in Anesthesiology; University of Oslo; Ullevaal Hospital; N-0407 Oslo, Norway;johan.rader@10ks.vio.no

(Accepted for publication October 3, 1998.)