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Practical Management of Pain, 3rd Edition

Burkey, Dell R. MD

doi: 10.1213/00000539-200102000-00064

Department of Anesthesia University of Pennsylvania Health System Philadelphia, PA

Practical Management of Pain, 3rd EditionP.Prithvi Raj, editor. St. Louis: Mosby Inc., 2000. ISBN: 0-8151-2569-0. 1070 pp. $160.00.

For many years, Raj’s Practical Management of Pain has been a definitive text for the care of the pain patient. Raj and his collaborators have again produced a comprehensive, clinically oriented and up-to-date third edition. There are 103 leading practitioners and researchers in the field of pain medicine who contributed to this work. In addition, an advisory board chose the most pertinent topics. The book is divided into eight parts, each with a different editor.

This 1070-page, 74-chapter edition is thoughtfully written and easily readable. The presentation of the material follows a logical progression. Part I outlines a brief history of pain medicine and describes the taxonomy of pain syndromes. The remaining chapters provide important information on the organization of pain centers, health care policy, and the economics of pain medicine.

Part II comments on the pathophysiological mechanisms of several acute and chronic pain states (i.e., neurogenic, ischemic, osteogenic, visceral, etc.) In addition, this section contains excellent illustrations of the anatomy and neurochemistry of pain pathways and pain mechanisms.

The use of a systematic approach in thoroughly assessing a pain problem (i.e., cancer, visceral, geriatric) is delineated in Part III. Several practical considerations and strategies are suggested which can simplify management.

Part V, “The Techniques of Pain Management,” is divided into three sections and includes 33 chapters. The section on special techniques was particularly interesting. The trainee as well as the practitioner will find this segment richly detailed and practical.

In this age of finite medical resources, outcome studies are needed to convince insurers that pain medicine is cost effective. These studies will assist the practitioner in his/her choice of the most appropriate and cost effective treatment for a particular patient. In Part VI, outcomes, efficacy, and complications from management of several common pain problems are discussed. Many more of these studies are needed if the practice of pain medicine is to survive.

The final three parts of the text covers pain management in special situations (i.e., emergency department, outer space, and at home), the future of pain medicine and needs of pain management, and appendices replete with very useful reference material. (i.e., pain organizations and societies, drugs in pain management, and equipment).

This reviewer enjoyed reviewing this edition of Raj’s Practical Management of Pain, for the first two editions served him well as a practitioner and this edition is definitely Raj’s finest.

© 2001 International Anesthesia Research Society