A.C.AdlerA.ChandrakantanR.S.LitmanCase Studies in Paediatric Anaesthesiavol 642019Cambridge University Press978-1-108-46551-9530Price £40. 64

Abstract

The majority of the chapters in Case Studies in Paediatric Anaesthesia are written by anaesthesiologists from Texas Children's Hospital. Some chapters also have contributions from a paediatrician, paediatric surgeon, research assistant, nurse practitioner, otolaryngologist, or paediatric cardiologist. Each chapter of the book is formatted around a several sentence case presentation, followed by a series of board-style questions-answers (Q&A). There are a total of 71 chapters written by 57 authors, ranging from introductory topics such as pharmacology, physiology, and normal physiologic vital sign parameters for a paediatric patient, to topics more specific such as the Fontan patient. The Q&A format reviews, in a general format, the salient preoperative, intraoperative, and postoperative anaesthetic considerations and presents practical solutions for each scenario. The clinical scenarios encourage critical thinking, promote decision-making skills, and eventually help the reader to retain the presented information. The book, using a case presentation format similar to a stem question for an oral board exam, is intended to provide a general overview of the diverse topics related to paediatric anaesthesia and pain management. The authors present the methods practised at their institutions and, when appropriate, alternative approaches, with advantages and disadvantages of each approach. The presentation of the questions related to the stem question is intended to provoke critical thinking, emphasising the most important scientific and clinical points. Some questions definitely make the reader think twice before answering. For example, ‘what can you tell the parents about neuroapoptosis?’ and ‘what should I tell parents about anaesthetic risks for a Glenn patient presenting for laparoscopic appendectomy?’ The Anaesthetic Neurotoxicity chapter is written by experts in the field, and offers practical recommendations to these tricky questions based on current literature and their experience. The textbook is not organised into sections and the chapters are prepared to be read in isolation. There is no repetition or overlap of the presented material. The first 49 chapters cover the most commonly encountered clinical scenarios in paediatric anaesthesia, while chapters 50–71 are devoted to paediatric pain management and cardiac anaesthesia. The case scenarios in the first 59 chapters focus on general topics of paediatric anaesthesia. These well-written chapters detail the management of specific surgical procedures, including orthopaedic, thoracic, dental, otolaryngologic, ophthalmologic, plastic surgery, burns, and trauma. The blood and transfusion chapter provides an excellent, detailed look at anaesthetic management of the paediatric patient with haematologic needs. Impressive and informative chapters are dedicated to up-to-date management of solid-organ transplantation and anaesthesia for fetal surgery. The authors provide a very detailed description of all aspects of performing ultrasound-guided paediatric regional anaesthesia with a focus on the most common nerve blocks in chapters 51–53. The figures and pictures are well selected, but unfortunately there are no online links with real-time dynamic videos demonstrating how to perform the blocks. Chapters 54–57 feature acute and chronic pain management discussions and provide a wealth of practical knowledge on distraction techniques and local anaesthetic toxicity. Providing anaesthesia/sedation for patients with congenital heart disease can be a challenge, especially in locations outside of the operating room. Chapters 58–71 provide concise overviews of the anaesthetic management of paediatric patients with cyanotic/acyanotic congenital cardiac lesions. Each chapter covers the anatomical and physiological features, unique considerations in pre-anaesthetic assessment, anaesthetic approaches, and postoperative management of the most common congenital heart lesions. This case-based up-to-date practical book is a comprehensive guide for anaesthesia residents and fellows, and for those preparing for their anaesthesia board examinations. The clinical guidance is provided in an easily digestible Q&A format; this will definitely meet the needs of the trainee during their paediatric anaesthesia rotation or the paediatric anaesthesia fellow preparing for examinations. Case scenarios are evenly covered, ranging from ‘bread and butter’ otolaryngologic procedures to a case that involves management of a patient with a ventricular assist device. It is very easy to read and provides an abundance of consistent and helpful clinical tips. Clear photos, well-reproduced tables, and instruction boxes make it easy to find essential concepts and information. The chapters conclude with suggested references to the most current literature for further exploration of topics. The book is written by authors in the USA only and does not represent an international contribution. It is a great first exposure to pertinent paediatric anaesthesia topics, which can then provoke the reader to explore topics in further depth elsewhere. The chapters are short, usually about four pages, but some are as short as two pages. Some of the chapters could be more comprehensive in scope and content, such as the Preoperative Anxiety, Emergence Delirium and Post Op Nausea and Vomiting chapters. This book provides a valuable starting point for anaesthesia trainees in their initial preparations for clinical case management and for preparing for oral examinations.