Anesthesiologist's Manual of Surgical Procedures

Abstract

Anesthesiologist's Manual of Surgical Procedures is a comprehensive textbook written jointly by surgeons and anaesthetists who have a broad knowledge and experience in their particular field. It contains a brief description of each surgical procedure written by a surgeon, with a summary of the factors of particular interest for an anaesthetist such as patient positioning, common complications, and the special requirements for a given operation. This is followed in each instance by detailed anaesthetic considerations from an anaesthetist expert in that sub-speciality. These include preoperative, intraoperative, and postoperative anaesthetic considerations, each detailed in a concise manner. Together with suggested monitoring, common perioperative complications, and various modalities of postoperative pain management are discussed. As the editors state in their preface, the book is intended to provide an easily accessible source of clinically relevant information about a wide variety of common and uncommon surgical procedures. They undoubtedly continue to achieve their objective. The third edition of this book has been revised with the addition of new material, for example minimally invasive cardiac surgery, more chapters on plastic surgery, office-based anaesthesia, and emergency procedures for the anesthesiologist. The reference list serves as an aid to the reader seeking more in-depth information. Although most of the contributors (including the editors) are from Stanford University School of Medicine, California, USA, the approach is very broadly based and applicable universally. The book is organized quite uniquely into 15 chapters representing various surgical specialities, such as: neurosurgery, ophthalmic surgery, otolaryngology, dental surgery, thoracic surgery, cardiovascular surgery, general surgery, obstetric/ gynecologic surgery, urology, orthopaedic surgery, plastic and reconstructive surgery, pediatric surgery, out-of-operating room procedures, office-based anesthesia, and emergency procedures for the anesthesiologist. Each chapter is subdivided into various surgical procedures. I enjoyed the chapter on neurosurgery as I have seen and anaesthetized patients for all the procedures described in it, including clipping of a giant intracranial aneurysm under deep hypothermic circulatory arrest. As the authors correctly point out, the anaesthetist should examine the cerebral angiogram/CT scan/MRI scan preoperatively to visualize the size, site, and nature of the aneurysm/tumour, although I suspect this is unusual in neuroanaesthetic practice in the UK. Surprisingly, there is no mention of the role of bilateral maxillary nerve block in controlling the haemodynamic responses during transphenoidal resection of a pituitary tumour, which is practised even in developing countries. In the chapter on ophthalmology, there was no mention of local resection of a choroidal melanoma, which has major anaesthetic implications, with the requirement for controlled hypotension. The chapters on thoracic surgery and cardiovascular surgery (adult and paediatric) are excellent. They adequately cover the fields of coronary revascularization (including off-pump coronary revascularization), valve replacement surgery, thoracic aortic surgery, correction of various congenital heart defects, percutaneous endovascular procedures, carotid endarterectomy, and heart/lung transplantation. There are some useful appendices at the end of the book, such as: preoperative laboratory testing and diagnostic studies; standard anaesthetic and pain management protocols for adult and paediatric patients; drug interactions; and special considerations in patients with latex allergy. The book is concise and well written with comprehensively illustrated anatomical diagrams. The American tendency to excessive use of abbreviations, medical symbols, and telegraphic sentence structure is its only irritation. There is no doubt that this new edition is a key reference for the anaesthetist confronted with an unfamiliar surgical procedure. Despite its ‘Americanisms’, it would be a useful addition to any departmental library.