Book And Multimedia Reviews: Media Review
Regional Anesthesia; Volume 12, Number 2 (April 2000) of Problems in Anesthesia Joseph M. Neal, MD, Michael F. Mulroy, MD, Spencer S. Liu, MD, Guest EditorsPhiladelphia: Lippincott, Williams & Wilkins. ISSN 0889-4698. 120 pp. $134 annual subscription for four issues or $56 per single issue.
This is an engaging little volume that provides the reader with a large amount of useful information. It is authored by experienced practitioners who offer technical pearls and well considered clinical observations. The use of regional anesthesia in the context of total patient care is kept at the forefront of the writing. This is evident whether the topic is the provision of anesthesia at a specific site of the body or its use within a particular arena of patient care ranging from the hospital operating room to the surgeon’s office.
The ten chapters are loosely organized into four areas: 1) advances in neuraxial, upper, and lower extremity blockade; 2) provision of regional anesthesia in particular settings both within and outside of the hospital; 3) considerations of outcomes and costs when regional anesthesia is compared with general anesthesia; and 4) a review of the current understanding of the complications and toxicities that can be caused by needle placement and injection of agent. The chapters are well written and to the point. The material is presented in a concise manner with a minimum of duplication from chapter to chapter. Each of the chapters ends with a conclusion that summarizes the material. Current thinking is reviewed before cutting-edge aspects of the field are introduced to challenge the reader with newer developments in techniques and types of local anesthetic. In general, the material is very well referenced with current citations.
Those who are new to the field as well as those who use regional anesthesia on a routine basis will find the handling of the material interesting and informative. Although small, the volume manages to cover a lot of ground. The reader will learn techniques to decrease the latency and prolong the duration of neural blockade. Newer approaches to provide continuous infusions of local anesthetic for prolonged peripheral nerve blocks are described. The role that combined spinal and epidural blockades plays in care of morbidly obese and obstetrical patients are explained, and current data supporting the cost effectiveness of regional over general anesthesia is presented. The authors give a well-balanced assessment of one approach over another in patient care. The final chapters emphasize the risks inherent in the placement of needles and injection of local anesthetic agents. Data from large surveys and individual case reports are cited to indicate the risk factors leading to neural damage and systemic toxicity.
At 120 pages, and 3 h of enjoyable reading, the work is of very high quality for those interested in the current state of regional anesthesia. This reviewer recommends this monograph.