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Book review

Oxford Textbook of Anaesthesia

European Journal of Anaesthesiology: March 2020 - Volume 37 - Issue 3 - p 256-257
doi: 10.1097/EJA.0000000000001114
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Editors: Jonathan G Hardman, Philip M Hopkins, and Michel M.R.F Struys

Publisher: Oxford University Press, 2019

ISBN-13: 9780198842453

“Oxford Textbook of Anaesthesia” belongs to Oxford Textbooks, an extensive educational series that offers wisdom and guidance and covers a number of specialties. This edition was published on 2nd May 2019 in paperback and contains the same information as the earlier e-book version.

The authors have put together a thorough and updated text of anaesthesia for both trainees and specialists. It represents an important basis of knowledge for clinical practice and is an excellent consultation tool. It has been published against a background of increasingly more complex practice, with great technological advances such as the use of smartphones in peri-operative settings, niche skills that may be technical or not, and the rise of new sub-specialties, particularly paediatric anaesthesia. Every day anaesthesiologists face challenging multifaceted settings during their clinical practice, in need of a reference source that is both comprehensive and easy to consult.

This sizable tome is written by clinicians for clinicians and covers all the fundamental aspects of anaesthesia with particular attention to the basic sciences that underpin clinical practice. It includes two volumes, divided into 13 sections, and 91 chapters, containing an impressive 1680 pages.

Volume 1 has six sections that cover the applied basic sciences and emphasise the importance of physiology, pharmacology and physics, from which the very principles of anaesthesia take root. The last three sections in Volume 1 concern evidence-based medicine and the practice and management of anaesthesia, including pre-operative assessment and post-surgical analgesia. Evidence for the importance of the latter is found in the expansion of training in pain management and the growth of pain services within health clinics. Anaesthesiologists have a key role in pain control as their training provides them with the tools required to control pain, from the appropriate use of a range of drugs to access to a variety of means for their delivery. This exemplifies the expansion of the role of the anaesthesiologist in hospitals and indicates the need to gain new skills.

Volume 2 is divided into seven sections and that deal with clinical practice. It opens with a section dedicated to the airway and vascular access with two additional chapters on conscious sedation, blood conservation and transfusion. This is followed by two other sections: one on regional anaesthesia and another on the conduct of anaesthesia in each surgical specialty. A separate section is dedicated to anaesthesia and concurrent disease.

Volume 2, section 10 is dedicated to paediatric anaesthesia. Although it is not specifically a paediatric text, this subject is still comprehensively covered. The success of neonatal and paediatric anaesthesia depends on the precise knowledge of the physiological, anatomical and pharmacological differences that exist between the child and the adult. Unlike the adult, the child is in a continuous and progressive evolution; body growth represents anatomical change, and is accompanied by developing function, maturing until gradually the adult form is reached. Precisely for this reason, the child cannot be considered “a small adult” but an individual being undergoing numerous developmental phases, each with its own particular characteristics. The aim of the authors is to provide all anaesthesiologists, whether in training or not, with the knowledge to deal with this highly specialised field.

The scope of modern clinical practice takes the anaesthesiologist out of the operating room into hospital departments such as radiology and endoscopy, for example. This represents a real challenge and requires experience and specific skills. A common problem is that experienced staff, adequate equipment and monitors are often absent. It is therefore really helpful that a key part of the Oxford textbook of anaesthesia is reserved for the conduct of anaesthesia outside the operating theatre.

The last section is on intensive care, but is limited to a few useful topics intended for a general anaesthesiologist and not to replace a specialist text on intensive care.

This book is clear and easy to understand, with schemes, diagrams and a number of highly illustrated images to aid learning. To make the topics easier to memorise, summary boxes have been used to highlight important clinical signs and characteristics and to facilitate rapid examination and consultation. The writing style is precise, clear, and easily comprehensible. This should help the reader to focus attention on the most important concepts that constitute the core of anaesthesia. I especially appreciated the way that the book succeeded in covering the basic principles of anaesthesia without neglecting sub-specialities such as regional anaesthesia, paediatrics and pain management. Another strong point of the text is the description of clinical situations that are accurately dissected and accompanied by practical tips for the management of difficult cases. The authors are international experts working under the direction of three editors, who are eminent figures in the field. I was happy to find the “Oxford Textbook of Anaesthesia” an exhaustive and useful book for reference, study and revision.

Valeria Di Franco, MD

Specialty Trainee in Anaesthesia and Intensive Care Medicine

Università Cattolica del Sacro Cuore

Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

© 2020 European Society of Anaesthesiology