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Anesthesiology:
doi: 10.1097/ALN.0b013e318260cc1f
Reviews of Educational Material

Anesthetic Pharmacology: Basic Principles and Clinical Practice, 2nd ed

Mintz, C. David M.D., Ph.D.

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Edited by Alex S. Evers, M.D., Mervyn Maze, M.B., Ch.B., and Evan D. Kharasch, M.D., Ph.D. Cambridge, United Kingdom: Cambridge University Press, 2011. Pages: 1,210. Price: $195.00.
A thorough understanding of anesthetic pharmacology is fundamental to clinical practice, and much of the ongoing scientific investigation in anesthesiology is in the field of pharmacology. Anesthetic Pharmacology: Basic Principles and Clinical Practice, 2nd Edition provides a review of this material that is current, comprehensive, and authoritative. The text is well designed, not only as a primary textbook for anesthesia trainees and more seasoned practitioners but also as a useful reference for nonclinician scientists engaged in anesthetic research.
The text is organized into four sections, which are further subdivided into a total of 71 chapters. The first section covers basic pharmacology, but in addition to the standard topics that appear in all such textbooks, there are interesting chapters on the emerging field of pharmacogenetics, the common drug interactions in anesthetic care, and the economics of pharmaceutical usage. The second section reviews mechanisms of drug action and the consequences for human physiology. The third section is a comprehensive review of each class of agents commonly used in the practice of perioperative medicine. This section is very extensive, but each component chapter is of a manageable length. The final section contains chapters that discuss anesthetic pharmacology in specific clinical contexts, such as anesthetic induction, pediatric patients, drug allergies, and so on. The contributing authors are well known experts, many of whom are engaged in active scientific investigation on their respective topics. In spite of the large number of contributors, the voice and style of the book remains remarkably consistent. The individual chapters, which typically range from 10 to 20 pages in length, are written in clear, concise language, and good use is made of figures and tables. The graphic style employed in the figures differs from chapter to chapter, but this does not detract from the book's effectiveness. The reference list for each chapter is extensive and there is a clear intent to give the reader a guide to the relevant primary scientific literature.
The second edition of this text differs markedly from the first. It contains one additional section and 17 new chapters, and most chapters that are shared between the books have been substantially updated. The contributor list is much expanded, and there is a considerable improvement in the quality of figures and graphics that are presented. Also, there is enhanced coverage of topics that are the focus of cutting edge research, such as the effects of anesthetic agents on the aged and the developing brain. There is also a greater emphasis on the evidence-based practice of perioperative medicine. The stated goal of the text, which is to bridge the divide between clinical practice of anesthesiology and basic research in pharmacology, has not changed. However, the first edition was designed as a complement to the Miller anesthesiology text, whereas the second edition can clearly stand alone.
Although this text should be of use to anyone interested in anesthetic pharmacology, the principle consumers of any medical textbook are fellows and resident physicians. It is vitally important for trainees both to read a pharmacology textbook as part of a standard curriculum and to have one available as a reference to complement standard texts on anesthetic practice. Anyone seeking to practice anesthesiology must acquire a working understanding of basic pharmacology and physiology as it relates to drug actions and an extensive knowledge of the pharmacology of drugs used in perioperative medicine. At least 42 of the 71 chapters cover information that is routinely tested on the Anesthesia Knowledge Test, the In-Training Exam, and the American Board of Anesthesiology written board exams, and the coverage of these topics is superior to what is achieved in comprehensive texts of anesthesiology. This alone should justify the resident physician in adding this text to his or her library. Alternatively, residents might consider an electronic version. The text is available as an e-book for a reduced price via Kindle and other e-book reader formats. Although this is a very nice option for those who are inclined to see 1,000-plus-page textbooks printed on paper as dinosaurs, one of the few flaws of this book is the absence of any other electronic enhancements of the kind that accompany some texts. There is no associated DVD or Web site with supplementary or condensed material, review questions, or a searchable index. Perhaps the authors will consider this in future editions.
In summary, Anesthetic Pharmacology: Basic Principles and Clinical Practice, 2nd Edition is a complete and authoritative review of the material advertised in its title. I recommend it highly to anesthesiology house staff, practicing anesthesiologists, and clinical or basic science researchers in the field.

© 2012 American Society of Anesthesiologists, Inc.

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