Atlas of Interventional Pain Management,2nd edition. S. D. Waldman. Saunders, Elsevier: Philadelphia, USA, 2004, 618 pp; indexed, illustrations by J. I. Bloch and C. H. Duckwall ISBN: 0-7216-0108-1; Price £130.00
This is a heavy 618 paged reference source, published 5 years after the first edition, which the author states, has become a ‘must-have resource’ for pain specialists. The second edition of the Atlas includes 22 new chapters featuring the latest techniques in pain management, new magnetic resonance imaging (MRI), computerized tomography (CT) and fluoroscopic images that have been added. The chapters have also been updated to reflect the most contemporary approaches in interventional pain management, e.g. radiofrequency techniques and the use of smaller, sharper and shorter needles.
The book is divided into eight chapters, each representing an anatomical part of the body: head, neck, shoulder etc. and the final chapter is about advanced interventional pain management techniques. Each chapter works systematically through all possible therapeutic nerve blocks, describing the indications, clinically relevant anatomy, technique, side effects and complications, and clinical pearls. The latter is a short piece after each section giving pragmatic advice on the management of the patient and other treatment options that may be helpful. There are 245 colour illustrations, depicting the relevant anatomy and the needling technique itself, relating this to fluoroscopy, CT and MRI, where necessary. The illustrations are beautifully drawn and give a clear and understandable view of the procedure, which is most helpful, both in performing and teaching the technique.
The text is designed to be used as a reference source for a single procedure, so it is repetitive when reading consecutive chapters. It is extremely useful as an ‘aide-memoir’ when performing a block, although some of the text descriptions are unnecessarily complicated. Indications are clearly stated and alternative possibilities are mentioned, but with no evidence-based outcome measures or assessment of the comparative incidence or severity of complications. For instance, neurolysis of the Gasserian ganglion is described with reference to the possibility of Horner's syndrome, weakness of muscles of mastication and a 6% incidence of anaesthesia dolorosa, but there are no comparative data for other techniques.
The book is a comprehensive reference source for interventional techniques, describing 112 nerve blocks, as well as subarachnoid neurolytic block, pituitary neuro-adenolysis, discography, epiduroscopy, the insertion of tunnelled epidural catheters, percutaneous vertebroplasty, spinal cord stimulation, and implanted reservoirs and infusion pumps. The illustrations are superb, and give a clear three-dimensional view of the anatomy. The techniques are well described and the nerve block techniques could be used by the regional anaesthetist. However, the book should be used with caution when a decision to perform a neuro-destructive procedure is to be made, as the author does not extend his remit into a comparison of the available therapeutic measures and the book, therefore, does not represent a balanced therapeutic approach. However, it can be highly recommended as a practical ‘how to do’ manual for interventional pain procedures.