Atlas of Anesthesia Volume VII: Pediatric Anesthesia.

Abstract

Associate Professor of Anesthesiology and PediatricsDepartment of AnesthesiologyThe University of North Carolina at Chapel HillChapel Hill, North Carolina 27599-7010Atlas of Anesthesia Volume VII: Pediatric Anesthesia. Series editor: Ronald D. Miller. Volume editor: William J. Greeley. Philadelphia, Current Medicine, 1999. Cost of book: $135. Cost of CD-ROM: $195. The multivolume series Atlas of Anesthesia has tried a visual method of presenting textbook information. The presentation mode of each volume is to deliver the information primarily in a format of tables, algorithms, figures, and pictures, all with descriptive headings. There is very little text. Pediatric Anesthesia , the seventh volume, seeks to use the visual media to “enhance the understanding of the medical conditions and surgical procedures encountered during the anesthetic management of children.”The book is divided into two sections. The first is divided into four chapters of basic principles: physiology, pharmacology, perioperative management, and regional anesthesia. Attempting to present highlights of the unique physiology of pediatric patients in 15 pages is a difficult task. Several of the figures and charts are classics and speak volumes. One or two are a bit confusing and relied on the heading to explain the context. The chapter on pharmacology presented a concise review of developmental changes, followed by an in-depth review of narcotics and muscle relaxants in children. In particular, the latter is easy to understand when presented as figures. It would have been nice to see inclusion of remifentanil and rapacuronium in this chapter to make it comprehensive. The chapter on perioperative management is well done, with great tips on topics such as premedication and parental presence. This chapter primarily uses charts to convey the information, but, again, it was easily assimilated. The last chapter in this section highlighted various central and peripheral nerve blocks. Obviously, this chapter contained a lot of illustrations with concise headings describing how to perform the blocks. I found it to be fairly inclusive of the blocks used in everyday practice.The second section of the book is dedicated to specific topics within pediatric anesthesia. The chapter on neonatal anesthesia had the difficult task of addressing not only physiology and pharmacology, but also specific types of surgery unique to neonates. Although some of the algorithms and tables for management of specific entities such as pyloric stenosis and congenital diaphragmatic hernia were overly simplified to present in this format, it was possible to quickly pick out the key issues in each type of condition.Chapters that were particularly well done included a good review of pediatric ophthalmologic surgery in chapter 10, detailed figures demonstrating the methods of delivering anesthesia during shared airways in chapter 11, and chapter 14, which deals with chronic diseases such as cerebral palsy and sickle cell disease. Because a picture can better depict the environment of performing anesthesia in outside locations, the chapter on this topic was very helpful with its numerous photographs (and the green tint of many of them conveyed the feeling many of us have when asked to go to those locations).Two chapters that stand out as fairly unique in their subject matter are those dealing with anesthesia for fetal surgery (chapter 15) and postoperative care (chapter 16). The photographs, tables, and charts are interesting in these areas not commonly addressed in pediatric anesthesia texts.The CD-ROM is identical in its material to the textbook. It was easy for a non–computer-literate type such as myself to use with either a MAC (68020 or better, minimum of 6 MB or RAM; System 7 or higher) or PC Windows (minimum 4 MB of RAM; Windows 3.1 or higher). I easily scrolled through the material and could quickly make slides from the tables and charts. The price is higher for the CD-ROM than for the textbook; again, one’s learning style and the convenience may justify the cost for some.I must confess that I actually purchased this textbook several months ago. I recognized the value of so many excellent tables and figures to be used as teaching slides in my academic practice. The authors have done a superb job of putting together information for concise presentation. Is this a textbook that one would have for reference? I think that depends on your method of learning. Certainly it is not an all-inclusive textbook of pediatric anesthesia and does not claim to replace more thorough texts. However, when I showed the atlas to residents, some thought they would learn better with this more visual format, and despite the cost, would like to have it on their shelves. It is an interesting and colorful addition to our pediatric anesthesia armamentarium.