Atlas of Regional Anesthesia

Abstract

This book has been updated from the 3rd edition after 4 yr. It is clearly laid out and incorporates current techniques in ultrasound-guided regional anaesthesia. In addition to the book, it is possible to download or stream additional multimedia content, such as nerve block videos, from a website at no extra cost. Alternatively, a DVD is available. There are seven contributing authors; however, most of the chapters are written by the editor. The book is well laid out and uses numerous glossy colour anatomical diagrams and ultrasound images which are easy to understand. Extensive cross-sectional diagrams enhance the anatomical concepts that the authors are trying to convey. The text is kept to a minimum with the majority of information being conveyed using diagrams and images. The book is divided into eight sections. The introductory section of two chapters focuses on the basics of regional anaesthesia including local anaesthetics, physics, and equipment. Local or regional anaesthesia is a pharmacologically induced reversible neuropathy. So it is interesting that pharmacological aspects are covered in a somewhat basic manner and that there is an absence of the basic physiology of nerve conduction. Likewise there is no guidance on the management of local anaesthetic toxicity or the use of lipid rescue. These weaknesses could be considered in keeping with the remit of the book as an atlas but could be easily included. Subsequent sections are arranged clearly on a regional anatomical basis; upper and lower extremities, head and neck, airway, and truncal blocks. The final two sections deal with neuraxial and chronic pain blocks. A consistent approach is used for the layout of diagrams, images, and text in each chapter and the reader is quickly familiarized with this. For each clinical procedure, the initial discussion starts with patient selection and the pharmacological choices. This is followed by applied anatomy and descriptions of traditional block techniques. The chapters also contain clinical ‘pearls’ to help in dealing with potential problems and for optimizing block outcomes. These ‘pearls’ are now a typical feature in such books. Those new to nerve block techniques will find that this approach provides a useful background to current ultrasound techniques. Traditionalists will also be reassured to find that traditional block techniques are mentioned in this latest edition of the book, perhaps in recognition that these still have a place. The ultrasound techniques, where feasible, follow on from the traditional techniques and are described in a similar style. Commonly performed upper and lower limb blocks are dealt with in detail and potential problems are clearly discussed. The sections on airway blocks deal with the more specialized nerve blocks. The section on chronic and cancer pain refers to specialized techniques that most anaesthetists would not perform routinely. This is particularly relevant to the chapters on coeliac and superior hypogastric plexus blocks, selective nerve root blocks, intrathecal catheter implantation, and spinal cord stimulation. In summary, this is an excellent general atlas of regional anaesthesia, with excellent anatomical diagrams, and ultrasound images. A potential criticism of the book would be that not enough detail is given to ultrasound techniques, although additional material is available in the downloadable videos or DVD where applicable. The chapters on intrathecal catheter implantation and spinal cord stimulation might be considered more appropriate for specialist books in chronic pain. It is essentially a reference atlas and the size of the book limits portability. Although we would hesitate in recommending this to every practitioner in regional anaesthesia, there is a place for this type of reference book in anaesthetic department libraries, or preferably in operating theatres, close to where it will be used.