Anesthesiology

Abstract

This concise book is intended to be a comprehensive, easy-to-read text aimed both at anesthesiology trainees preparing for examinations and experienced practitioners needing a succinct reference guide. Authored by a number of experienced practitioners in the field of anesthesiology from across the United States, the editors have structured this textbook to describe common challenges in clinical anesthesia in a question–answer format. The book comprises 12 main, specialty-specific sections and a total of 60 chapters. Each chapter starts with a hypothetical clinical scenario relevant to a particular subspecialty in anesthesiology. A large number of chapters address the cardiovascular system and anesthetic considerations, for example, ischemic heart disease, valvular abnormalities, or uncommon conditions such as care of a patient with a transplanted heart presenting for noncardiac surgery. In every chapter, the starting clinical scenarios are well structured and provide a comprehensive account of the clinical issue, including relevant investigations. The main content of each chapter is in a format of a series of simple questions and succinct answers. Wherever indicated, basic understanding of anatomy and physiology is discussed, such as applied anatomy of coronary circulation, the denervated heart or nomenclature, and classification of pacemakers. The anesthetic implications in each of these situations are covered explicitly and referenced appropriately. The style of presentation is one of the main strengths of this book. Using a problem-based approach, the authors immediately direct readers to the matter at hand, that is, the clinical situation and how to safely provide anesthesia care while facilitating critical thinking and problem-solving skills. The questions guide readers through the logical steps in safe anesthetic management of various elective and emergency cases in great detail. Current evidence and guidelines are cited wherever necessary, such as the 2014 ACC/AHA Guidelines on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery,1 or the Universal Definition of Myocardial infarction.2 Chapters on intraoperative coagulopathies, difficult airway management, and obstetric anesthesia also cover the applied pathophysiology and anesthetic implications quite well. The section on pediatric anesthesiology topics is comprehensive, and particularly, neonatal resuscitation and premature infant are described. Because this is the first edition of this book, it can be appraised using Yao and Artusio’s Anesthesiology: Problem-Oriented Patient Management,3 a core textbook, now in its 8th edition. Both books are laid out in a problem-based format using clinically relevant case scenarios. The table of contents is similar; both books deal with the topics in a well-organized questionanswer format. The Yao and Artusio book is a major reference text and covers each topic in extensive detail, with preoperative, intraoperative, and postoperative phases clearly yet compactly presented, referenced, and well illustrated where appropriate. The Anesthesiology case reviews book touches on the most relevant topics; however, the level of detail is not as extensive as that of the Yao and Artusio book. Some important and current practices in anesthesiology have been overlooked in this book, such as important considerations for use of newer reversal agents for nondepolarizing neuromuscular blockers (sugammadex) or use of gastric ultrasound for patients with a full stomach. Moreover, obstructive sleep apnea is not described as a condition in its own right, but as an association with obesity. The recent updated STOP-Bang questionnaire4 and the 2016 Society of Anesthesia and Sleep Medicine Guidelines on Preoperative Screening and Assessment of Adult Patients with Obstructive Sleep Apnea5 are also missing. In the regional anesthesia chapters, brachial plexus anatomy illustrations are presented in color; however, there is limited mention of the use of ultrasound for nerve blocks, a standard of care practiced in many institutions worldwide. The addition of colorful illustrations, graphs, and figures could make this book more readable. Some integral anesthesia topics such as acute and chronic pain management are mentioned very superficially, and some readers may find this an important exclusion of a significant knowledge area. Overall, this is a good book, serving as a handy resource for both trainees and clinicians who like to review high-yield topics in a case-based format. This book finds its place somewhere between being a useful concise pocket handbook for bedside reference, such as Oxford Handbook for Anesthesia,6 and a case-based reference book with more detail, such as the Yao and Artusio book.3 In the end, if a reader would like to use a textbook that touches on most of the relevant clinical topics in anesthesia or prepare for examinations, this book will serve as an important addition to their collection of useful resources. Najia Hasan, MBBS, FRCADepartment of Anaesthesia and Intensive CarePrince Charles HospitalCwm Taf University Health BoardWales, United Kingdom Mandeep Singh, MBBS, MD, MSc, FRCPCDepartment of Anesthesiology and Pain ManagementToronto Western HospitalUniversity Health NetworkUniversity of TorontoToronto, Ontario, CanadaDepartment of Anaesthesiology and Pain ManagementWomen’s College HospitalToronto, Ontario, CanadaToronto Sleep and Pulmonary CentreToronto, Ontario, Canada[email protected]