Anesthesiologist’s Manual of Surgical Procedures. By Richard A. Jaffe, Stanley I. Simpons. Philadelphia, Lippincott Williams & Wilkins, 1999. Pages: 1,200. Price: $125.00.
Medge D. Owen, M.D., Wake Forest University Medical Center, Winston-Salem, North Carolina. mowen@wfubmc.edu
I still remember the first time I read this book, preparing for an in-training exam, after I was given a stack of references from my attending physician to familiarize myself with various surgical procedures and their anesthetic implications. I was wondering how I could absorb what appeared to be an overwhelming amount of information overnight, and could clearly have benefited from this book. Of course, I provided anesthesia for the patient the next day, and demonstrated at least adequate reading to satisfy my attending physician’s inquiry. Since then, I frequently visit this book when in doubt about unfamiliar surgical procedures.
This book is a true collaborative contribution from surgeons and anesthesiologists. It is neither a textbook with lengthy descriptions, nor is it a procedures book with a lot of detailed descriptive diagrams; it is a product from the extracts of both. It covers almost any surgical and anesthesia procedure, and allows readers to be able to get acquainted efficiently.
Chapters in the book are classified by surgical subspecialties with descriptions of individual surgical procedures in each chapter, starting with techniques by surgical subspecialists, including the position, incision site, special instrumentation, estimated blood loss, surgical time, and common surgical complications and their incidence. This is followed by the subspecialty anesthesiologist’s description of anesthetic considerations for this type of surgery, including preoperative evaluation (systemic implications of the disease process, special concerns, necessary preoperative laboratory tests, and premedications), intraoperative management (divided into induction, maintenance, emergence, and some special considerations such as fluid and blood products management), positioning, special monitoring, unique anesthesia techniques (controlled hypothermia, cardiac arrest, control hypotension, and others), and postoperative care, mainly focusing on postoperative complications and pain management. This book also contains a lot of illustrations and tables; I found these extremely helpful for understanding the features of surgery, as well as the demands of anesthesia. The cited references certainly would help those wishing to know more in-depth information about the procedures.
This new edition is 200 pages longer than the previous one. In addition to being revised with surgical techniques and anesthetic considerations, the authors added several new chapters and sections, such as surgery for epilepsy, reconstructive operations for sleep disorder, minimally invasive (off-pump) coronary bypass surgery, an entire chapter of laparoscopic operations, expanded coverage for emergency operations for different traumatic injuries, a chapter on pediatric surgery that was expanded to include coverage of complicated congenital cardiovascular surgeries, a chapter on out of operating room surgery, and the additions to sections on preoperative evaluation and postoperative pain management for adult and pediatric patients.
This is an excellent reference book and covers almost all aspects of surgical procedures and anesthetic considerations. In my view, it would be suitable for all levels of anesthesia providers including residents, certified registered nurse anesthetists, and attending anesthesiologists; it also could be a valuable resource for our surgical colleagues to better understand our special concerns regarding certain procedures or patient populations. I would strongly recommend this book, and would keep it in the operating room office or break room.
