NMS Clinical Manual of Anesthesia.

By Randall S. Glidden, M.D. Lippincott, Williams & Wilkins, Baltimore, 2002. Pages: 186. ISBN: 0-7817-3738-9. Price: $18.95.

This handbook aims to provide medical students rotating in anesthesiology with the insight and background necessary for understanding anesthetic practice. The intent of the authors, stated in the first chapter, is to present information necessary for an anesthesiologist to deliver an anesthetic with emphasis on the medical basis for the interventions. Patient safety, provided through preoperative evaluation, preparation, and monitoring, is a central issue for our specialty and warrants emphasis in handbooks such as this, especially those directed to medical students who might otherwise have little interest in the specialty. However, these topics as well as anesthetic options (conscious sedation, regional, general) are introduced following chapters addressing the medications of general anesthesia (also presented in an order unlike that used in operating rooms). More attention is needed in subsequent editions for an orderly presentation of information.

There is a long history of texts designed to make basic anesthetic concepts palatable to students in an entertaining manner. (Who can forget the infamous Anesthesia for the Uninterested ?) Indeed, a colloquial style can be a helpful aid to teaching in some settings. However, by their nature medical students have demonstrated an ability to read, process, and integrate complex information delivered in information-rich, entertainment-free documents and texts. Storytelling, the writing style used early in this handbook to address topics pertinent to basic anesthetic management, seems condescending to the reader who has demonstrated the intellectual skills required for acceptance into medical school and progression to clinical rotations. Later in the book, storytelling is replaced by conversational-style writing that is not concise. Perhaps this reflects my personal bias, but as a clinician with experience in shepherding medical students through anesthesia rotations, I question the effectiveness of these writing styles for the intended intellectually adept audience.

A handbook should allow the reader to quickly obtain information through tables and figures, affording the ability to efficiently pursue information in more substantive textbooks. This handbook fails in providing concise, useful information in an organized, practical order necessary for medical students to appreciate patient care in anesthesia. Handbooks in anesthesiology representing the specialty in a more professional and authoritative tone are available and recommended to the intelligent and insightful audience for whom this handbook is intended.