Smith’s Anesthesia for Infants and Children, 7th ed.
Motoyama EK, Davis PJ, eds. Philadelphia: C. V. Mosby, 2005. ISBN 0323026478. 1,120 pages (book w/ DVD). $175.00.
The 7th edition of Smith’s Anesthesia for Infants and Children continues to expand the horizons of pediatric anesthesia practice. The first published in 1959 was written almost entirely by Dr. Robert Smith. It has now progressed to a 1,200 page volume with over 75 contributors. Dr. Smith was a true pioneer in anesthesiology as he established the use of the precordial stethoscope and was among the first to advocate for patient monitoring and safety. This thoroughly detailed and up-to-date edition continues to preserve his vision and remains a classic.
The book is organized into four sections. These sections cover the basic principles and general approaches of pediatric anesthesia and provide guidelines for clinical management of special surgical problems and other associated problems of pediatric anesthesia. The editor’s intentions are to give anesthesia care providers comprehensive coverage of the physiology, pharmacology, and clinical anesthesia management of infants and children of all ages. Along with new topics of interest being added, older chapters have been revised, some by new contributors to this edition.
This book is highly instructive. In the “Basic Principles” section, the revised chapter “Regulation of Fluids and Electrolytes in Infants and Children” serves as an excellent refresher course. The chapter begins with the anatomy of the kidney and goes on to an extensive description of fluids and electrolytes. Well-placed, highlighted tables and charts contain essential information and are informative as quickly accessible sources of reference. The listing of etiologies and treatments of various abnormalities, such as hypnatremia, hypernatremia, is worthwhile for clinicians.
Under the “General Approaches” section, there are several new and noteworthy topics. The “Psychological Aspects of Pediatrics” is one that brings together many of the relevant studies of the last decade and presents them in a readable chapter. The “Pain Management in Children” chapter is timely and important as it includes updated material on certain aspects of developmental data, discusses the assessment of pain in children, as well as pharmacological and behavioral approaches. These noted improvements in pain management in children are extremely relevant. As anesthesiologists become more involved in hospital-wide initiatives, our expertise becomes an important factor in improving pain control for children. This chapter is useful in fulfilling a necessary educational need in this area.
The “Clinical Management” section now includes a chapter on “Anesthesia for Fetal Surgery” as well as a useful section on Bariatic Surgery. Chapters on Neonatal Surgery, Cardiovascular Surgery, and Orthopedics continue to be innovative and relevant. Again, tables of interest abound, in such subjects as dwarfism, scoliosis, and congenital anomalies associated with heart defects.
There is new content provided on “Anesthesia and Sedation for Pediatric Procedures Outside the Operating Room.” This important chapter points out how this “outfield” can be, and often is, challenging and hazardous. Not only are clinicians facing increasing stress within the operating room, they commonly encounter pressures from outside as well. For this reason, nonanesthesiologists continue to be interested in providing their own “sedation” and analgesia. These valuable pages provide insight into these dilemmas and provide useful guidelines for practice and standards of care. Along with safe approaches to care, this chapter supplies information to support those practitioners who want to maintain high safety standards and monitoring for pediatric patients undergoing sedation.
The reference materials found inside the front cover and in the Appendices present practical, frequently referred-to information such as Pediatric Drug Dosage, an Index of Pediatric Syndromes and their Anesthetic Implications, and Prophylaxis for Endocarditis as recommended by the American Heart Association.
This newest edition, in keeping with advancing technology, includes a DVD with video segments which underline a number of subjects that may be new areas for some practitioners. These clips give instruction on the use of fiberoptic intubation, techniques on regional anesthesia and one-lung ventilation. The clips also include a pathologist’s review of normal and abnormal cardiac anatomy. Finally, video presentations of common pediatric surgeries are shown. These include a pyloromyotomy, repair of a congenital diaphragmatic hernia and a thoracoscopic left upper lobectomy. Both normal and abnormal pediatric airway slides are included which are helpful for medical teaching. For those of us who benefit from visual learning, this is a worthwhile addition.
In summary, this textbook is expansive, educational, and enlightening. For the price, it is the best educational experience that pediatric anesthesiologists (and nonanesthesiologists) can buy. For the quality-driven, patient-centered pediatric anesthesiologist, this book is essential.
Claudia Venable, MD
Assistant Professor of Anesthesiology
Emory University School of Medicine and
Childrens Healthcare of Atlanta-Egleston