Atlas of Anesthesia. Vol VII. Pediatric Anesthesia.

Abstract

Atlas of Anesthesia. Vol VII. Pediatric Anesthesia., Ronald D. Miller, series ed. William J. Greeley, volume ed. Philadelphia: Churchill Livingstone, 1999. ISBN 0-443-07964-1. 230 pages, $135.00. CD-ROM, ISBN 0-443-06511-X. 4MB, $195.00. Why an atlas of pediatric anesthesiology? Ronald D. Miller, MD, the series editor, explains: “The educational transmission of the combined cognitive and technical aspects of anesthesia can be markedly facilitated by illustrations, including images, graphs, decision-making trees, and algorithms.” The stated goal is to provide teaching materials of the finest quality in easily accessible formats that allow anesthesiology to become a visual specialty in a way that has never been attempted previously. This volume of Atlas of Anesthesia presents, in an attractive combination of figures, text, and tables, an up-to-date summary of the physiologic and scientific principles of the anesthetic care of children. As stated in the preface, the volume begins with a general overview of basic principles in the care of pediatric patients. The introductory section includes chapters on unique physiology of children, special pharmacology issues, equipment and monitoring concerns, and the general perioperative approach to children. The remainder of the volume focuses on specific topics within pediatric anesthesiology, such as the anesthetic care of children for cardiovascular surgery and neurosurgery, as well as postoperative care. The volume editor and 29 contributing authors are recognized leaders in their areas of expertise. However, the ability to summarize controversial issues in limited-size tables or graphs can be a challenge and is not consistently presented in this volume. For example, the legend of Figure 10-9 refers to the utility of succinylcholine in children with suspected open globe injury, although the figure itself suggests that it is contraindicated. Table 11-2 lists recent or current respiratory infection and nasal congestion as preoperative “concerns” in children presenting for myringotomy with tympanotomy tube placement, but without a discussion of the clinical implications. Some authors recognized this limitation (Chapter 14, “Chronic Disorders”) and chose to only outline specific information (mostly in a table format) about selected conditions in which the pathophysiology and treatment are likely to affect anesthetic management, and they refer the reader to the more traditional pediatric anesthesia texts. The chapter on regional anesthesia is ideally suited to the atlas format and will be used to complement standard texts on the subject. The chapter is a succinct synopsis of the most useful pediatric regional techniques. In many instances, however, the chapter reflects the author’s own practice with no, or gratuitous referencing (e.g., Figure 4-7 “Spinal Dosing” and Figure 4-12 “Local Anesthetics with Fentanyl Epidural Infusions”). The chapter on anesthesia for fetal surgery strikes a particularly good balance between using text and illustrations. The greatest value of this volume lies in the beautiful, wellconstructed illustrations and tables. Lecturers and educators will, no doubt, use these extensively as teaching tools. For them, the ability to retrieve these graphics from the easy-to-use CD-ROM is a definite advantage. The combination (Volume/CD-ROM) may not belong in every anesthesia resident’s “Welcome Package”, but certainly must be available in the anesthesia library for frequent reference and use.