C. Dodds, C. Kumar and F. Servin
Oxford University Press, 2017.
This is the second edition of Anaesthesia for the Elderly Patient, the first now being 10 years old. This edition updates all the chapters and adds in new content such as anaesthesia for non-theatre environments.
The book provides a comprehensive summary of anaesthesia for the elderly patient being well laid out and logically structured with clear sections. The opening chapter explains the changing demographics and how this is likely to affect us in the future. It touches on some of the wider difficulties such as provision and cost of healthcare in societies with an ageing population. The next two chapters focus on physiology and pharmacology. The physiology chapter doesn’t just concentrate on how individual organ systems change with ageing and how that affects patients undergoing anaesthesia, it also looks at the molecular basis of ageing and how it differs in individuals which is an interesting side. The pharmacology chapter covers the pharmacokinetics and pharmacodynamics in the elderly as well as looking at specific individual drugs commonly used.
The following chapters cover pre-operative assessment and preparation and anaesthesia for the elderly in various sub-specialities. The pre-operative assessment chapter covers assessment and optimisation of organ systems prior to surgery as you’d expect, and also covers aspects such as behavioural changes that occur in hospitals and the effect of dementia on outcomes. A minor criticism of this chapter would be that some sections are rather long and not divided up by sub-headings which would make reading a little easier.
The chapters that cover anaesthesia for sub-specialities start with general considerations and then look at issues specific to operations commonly performed in the elderly, such as trans-urethral resection of the prostate. These are well written and look at some of the common debates such as general versus regional anaesthesia. The chapter on postoperative care and analgesia discusses common problems in recovery, such as delirium and agitation, and provide a useful framework for managing these complications.
The final chapters include a brief one on intensive care and the elderly, anaesthesia for the non-theatre environment, cognitive dysfunction and sleep disorders, and one discussing ethics and the law. These all provide a clear, concise summary of the issues relevant to the anaesthetist. Anaesthesia for the non-theatre environment is a welcome addition as it covers general considerations as well as management in specialised non-theatre environments which are increasingly part of an anaesthetist's work.
I think this book is a worthwhile purchase for the trainee anaesthetist looking to expand their knowledge, or the senior one looking to refresh and update their's.
Specialty Trainee in Anaesthesia