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Ultrasound-Guided Regional Anesthesia, 2nd ed

MacLean, David MD; Abdallah, Faraj W. MD

doi: 10.1213/ANE.0000000000002347
Books, Multimedia, and Meeting Reviews
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Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada

Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada, Department of Anesthesia and Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Ontario, Canada, AbdallahF@smh.ca

Funding: This work was supported by departmental funding. F.W.A. is supported by the Merit Award Program, Department of Anesthesia, University of Toronto.

Fundamental knowledge of ultrasound and its application to regional anesthesia is no longer the sole purview of the regional anesthesiologist. Ultrasound is quickly becoming an indispensable tool in the performance of modern regional anesthesia throughout the world, where its increasing ubiquity has spurred refinement of traditional techniques and enabled the development of new, precise, and accurately targeted fascial plane blocks. As the breadth and variety of these approaches have continued to grow, so too has interest among trainees and nonregional anesthesiologists eager to perform these blocks. This necessitates that anesthesiologists of all types have at their disposal a resource for succinct review of each regional technique.

Ultrasound Guided Regional Anesthesia once again provides a concise and invaluable resource specially tailored to address this need. In this much anticipated second edition, Dr Stuart Grant and Dr David Auyong have updated their highly accessible reference while retaining a format and style that appeals as much to the novice trainee as the seasoned regional anesthesiologist. The brevity, clarity, and organization of the text are again its unique advantage. As veteran instructors of regional anesthesia and respected authorities in their field, the authors draw on their extensive experience to maintain a straightforward and conversational narrative, where a methodical and stepwise approach is presented for every commonly performed block. All are accompanied by new and improved ultrasonographic images, and several new blocks are also introduced, including the axillary nerve block, suprascapular block, fascia iliaca block, lateral femoral cutaneous nerve block, and adductor canal block. The authors smartly preserve their acclaimed approach to the demonstration of sonoanatomy, allowing the reader to compare unlabeled images side-by-side against color annotations. As before, each discussion is ripe with pearls to help the reader achieve a successful block while avoiding common pitfalls.

The structure of the 268-page edition is divided into 4 chapters, first covering basic principles of ultrasonography, followed by blocks of the upper limb, the lower limb, and the trunk and spine, respectively. Of particular interest to the novice regional anesthesiologist is the opening chapter, which deftly summarizes key concepts including ultrasound physics, needling techniques, and positioning, and also provides—perhaps most importantly—insightful tips on the “keys to ultrasound success,” with the aim to improve block success through an improved scanning technique. The first chapter concludes with a new appendix, “What Block for What Surgery?” that serves to help demystify the myriad blocks available for upper and lower limb surgery, all of which are detailed in the subsequent chapters. In these, each block is distilled into a brief master-class tutorial, covering a step-by-step approach informed by the authors’ extensive teaching experience. The consistent format of each description—organized by introduction, anatomy, clinical applications, ultrasound set-up, scanning technique, alternative techniques, catheters, complications, and finally, pearls—allows the reader to rapidly identify key information. This standardized structure is the cornerstone of the book’s success and lends itself equally well to use either as a clinical bedside reference or as a comprehensive guide.

Of course, readers will require a strong knowledge of anatomy to gain the most from the authors’ descriptions. Although many well-illustrated figures are scattered throughout the text, the use of a supplemental anatomy reference would benefit the novice regional anesthesiologist by further informing the context of the presented sonoanatomy.

The formatting of the book is the only aspect that leaves room for development in future editions. Occasional large blank areas adjacent to some figures hint at the possibility for additional illustration, although the present images excellently complement the text. The table, “What Block for What Surgery?” serves as an important reference, although the density and variable formatting of the text might impede its rapid interpretation by some readers. Lastly, the ease of navigation might be improved by page headers or by justification between chapter labels present at the edge of each page. Yet, none of these decidedly minor criticisms detracts from the exceptional quality of the authors’ work.

Overall, the second edition of Ultrasound Guided Regional Anesthesia builds on the successes of its predecessor, maintaining the concise style of the original while introducing several new blocks alongside a refined complement of ultrasonographic images. Universally appealing to all skill levels, this text makes a worthy addition to the library of any practitioner seeking to enhance their understanding of regional anesthesia.

David MacLean, MDDepartment of AnesthesiaUniversity of TorontoToronto, Ontario, Canada

Faraj W. Abdallah, MDDepartment of AnesthesiaUniversity of TorontoToronto, Ontario, CanadaDepartment of Anesthesia and Keenan Research CentreLi Ka Shing Knowledge InstituteSt Michael’s HospitalToronto, Ontario, CanadaAbdallahF@smh.ca

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