Essential Anesthesia: From Science to Practice. Euliano TY, Gravenstein JS. Cambridge, UK: Cambridge University Press, 2005. ISBN 0-521-53600-6. 245 pages, $39.99.
More medical students express interest in anesthesiology today than a decade ago. Departments need an introductory textbook for these students, one that will hopefully arouse their interest and even entice them into the specialty. This book aims at that market, as well as the medical and nonmedical visitors to the operating rooms.
The authors, educators from the University of Florida, describe their paperback book as “a concise, accessible introduction. . .[that] provides a brief, broad overview of the science and practice of anesthesia.” This reviewer agrees, and finds that its convenient size, attractive presentation, and logical organization support the description. The authors have organized the book into three sections: 114 pages devoted to clinical management, 90 pages to applied physiology and pharmacology, and 32 pages for descriptions of eight clinical cases.
Students can start anywhere in the book, jump from topic to topic, and learn something useful and interesting. The copious subheadings and uniform style facilitate such browsing. There is an 8-page index, but it doesn’t seem particularly useful, probably because this book is an overview and not a reference handbook. The reviewer could not find, for instance, information about dexmedetomidine or forced-air warmers.
The eight clinical cases cover situations commonly encountered, and procedures commonly performed, by anesthesiologists, e.g., cesarean section under regional anesthesia, gastric bypass under general anesthesia, and breast biopsy under conscious sedation. Teaching anesthesiologists will particularly like the orderly presentation of these cases, with assessments and responses serially following case facts. Each case starts with learning objectives and includes many teaching points. Faculty can easily use these cases as the organizing theme for student conferences.
The book has a chatty style that readers will certainly notice, and find lovable or annoying or probably both. It is replete with “we” sentences, with a few “you” sentences interspersed. Representative examples: “Once we get both air and blood into the lungs, oxygen must traverse the alveolar membrane.” And, “Should you obtain a history of obstructive sleep apnea during the anesthesia pre-operative evaluation, you may have to obtain further studies.” The text also has numerous awkward and slangy statements, and oversimplifications, sure to distract many readers. Respective examples: “Common are patients with allergies to latex and to drugs,” “Propofol is the poster child agent for TIVA,” and “The brain is an amazing organ.”
Perhaps the reviewer is too old to judge fairly young-speak. The authors did explain the title, “Essential Anesthesia” for people like the reviewer in their opening sentence as, “the Essentials of Anesthesia.” The “army-of-one” generation may dismiss these style comments as grammar-obsessed. Some will not agree though and even find the following sentence subject to humorous misinterpretations: “We begin hyperventilation after conferring with the neurosurgeon, who also requests mannitol.”
The numerous figures and tables are clear and helpful, and a definite strength of the textbook. The book broadly covers anesthesiology in its 250 pages and includes some interesting and quirky anecdotes and facts. Few references are included. The reader is referred to a Web site at the institution of the author for some additional information, which seemed only moderately helpful.
Most departments use larger and more expensive textbooks, written for anesthesiology residents, for their rotating medical students. Essential Anesthesia is more appropriate for students and definitely more interesting, but whether it will replace the larger textbooks or reference handbooks is unclear.
Robert E. Johnstone, MD
Professor of Anesthesiology
West Virginia University