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Book Reviews

Peripheral Nerve Blocks and Peri-operative Pain Relief

Jepegnanam, C.*

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European Journal of Anaesthesiology: April 2006 - Volume 23 - Issue 4 - p 357-358
doi: 10.1017/S0265021506220593
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J. Barrett, D. Harmon, F. Loughnane, B. Finucane, G. Shorten, Elsevier: Cambridge, UK, 2004, 150 pp; indexed, illustrated, ISBN: 0-7020-2717-0; Price £76.00

As a practising anaesthetist with special interest in peripheral nerve blocks and perioperative pain management, I found reviewing this book to be an interesting experience.

The editors of this book have been involved in running cadaver-based workshops on peripheral nerve blocks for the past 4 yr at least. They have also responded to the feedback from these courses. As they state in the preface their aim was to produce a ‘stand-alone, effective educational tool’ and in this I believe they have largely succeeded.

The book begins with a very clear introduction stating the layout of the book, the readership and their view of how best to use the book. There is also a brief history of the development of regional anaesthesia and a look to the future. Chapter 3 deals with the applied anatomy and physiology of the peripheral nerve and pharmacology of local anaesthetics. The illustrations here are very clear and useful as they are throughout the book. The table of the comparative pharmacology of local anaesthetics could have been updated.

The chapter on general indications and contraindication is comprehensive supported by excellent illustrations of dermatomes, myotomes and osseous innervations. The chapter also deals with the issues of anticoagulation and regional anaesthesia.

Part one of the book concludes with further chapters on complications, safety and materials required. The chapter on peripheral nerve block materials provides a good summary of electrophysiology and the physics involved in nerve stimulation. There are, however, some annoying misprints which could have been eliminated with careful proof reading. For example, Figure 4.1 has two structures marked 5, though no blood vessels or muscles are shown in the figure: the legends for them are shown in the text below and Figure 5.2 has 0.2 min instead of 2 min injection time.

Part two of the book deals with specific nerve blocks. Each chapter follows the same format with indications, contraindications, anatomy, surface anatomy, techniques, adverse effects and a highlighted box with clinical pearls. The book deals with a comprehensive list of peripheral nerve blocks starting from cervical plexus to the ankle and almost everything in between! From my practice, the only block I would have liked to have seen and that was not included was the lithotomy approach for the sciatic nerve.

There are many books on peripheral nerve blocks and all of them describe the blocks in more or less the same manner. What makes this book stand out is the clarity of the illustrations. Each block description is accompanied by photographs of surface markings, cadaver specimen, skeletal structure where required and line diagrams. This book has in it everything required to learn a peripheral nerve block from basic principles to execution of the block.

This book comes with a digital videodisk (DVD) that has contains the illustrations from the book. The DVD also has magnetic resonance images (MRI) showing the spread of local anaesthetics and a video collection that demonstrates surface anatomy and procedure of each block on volunteers. In addition to the resource on the DVD, there is a link to a web site which has review questions on each chapter and all the illustrations.

This book will be a valuable resource for any department of anaesthesia and a must for any department actively involved in teaching regional blocks to the trainees. Trainees in anaesthesia who want one book to learn peripheral nerve blocks would not go wrong with this one.

© 2006 European Society of Anaesthesiology