Case-based Anesthesia: Clinical Learning Guides

Abstract

Northwestern University Feinberg School of Medicine, Chicago, Illinois. n-nathan@northwestern.eduCase-based Anesthesia: Clinical Learning Guides. Edited by George Shorten, Stephen F. Dierdorf, M.D., Gabriella Iohom, M.D., Ph.D., Christopher J. O'Connor, M.D., and Charles W. Hogue, Jr., M.D. Philadelphia, Wolters Kluwer-Lippincott Williams & Wilkins, 2009. Pages: 237. Price: $99.00.The authors of Cased-based Anesthesia: Clinical Learning Guides have aimed to produce a text that is unique among the voluminous and diverse selection of clinically oriented books now available. Case-based Anesthesia is most singular in its structure and format, amalgamating some of the most effective elements of question-answer based texts, such as Anesthesiology: Problem Oriented Patient Management (Yao, FS, Lippincott Williams & Wilkins), while incorporating the brevity and readability of review books, as exemplified by Anesthesiology Review (Faust, RJ, Churchill Livingstone). Case-based Anesthesia does not intend to have comprehensive scope, nor does it brand itself as an exhaustive review book for board certification. Each of its 60 chapters is approximately four pages long and begins with a case presentation, succeeded by open-ended questions and their attendant discussion, often thoughtfully using graphs, tables, and images. Each case-based chapter follows one of two formats: “step-by-step” chapters lead the reader through a clinical scenario prospectively, whereas subjects configured into a “reflection” framework observe the topic retrospectively. The chapters conclude with a Key Messages list of bullet points summarizing the salient themes of the subject followed by three self-study questions with answers.Several elements of Case-based Anesthesia are noteworthy. Most importantly, it is a genuinely readable text because of the concise and cogent discussions of each topic. Although the succinct treatment of the subject matter prohibits the discussion from achieving its conceivable depths to some degree, this is largely compensated for by a robust chapter reference section composed of citations germane to the topic at hand. The majority of cited references in each chapter are from within 5 yr of the publication date, but the authors did not exclude “classic” articles essential to the bibliography. The book itself encompasses admirable latitudes of clinical practice, recognizing important issues within every subspecialty of clinical anesthesiology while also keeping the reader abreast of several “hot topics.” Examples of the latter include “Emergency Reversal of Rocuronium-induced Meeting Abstracts Using Sugammadex” and “Levosimendan and Acute Heart Failure.”Three elements of Case-based Anesthesia potentially detract from its utility. The methodology employed by the editors in selecting the various discussion topics is not readily apparent. Indeed, core topics such as perioperative hypertension and anaphylaxis share as much equivalent literary real estate as mitochondrial disease and occupational exposure to anesthetics. In addition, the chapters are not organized in a sequence relating to their subspecialty or temporal placement in the perianesthetic care of patients. This makes locating subject matter cumbersome. Finally, although the writing and editing of the primary content are superb, the concluding self-test questions are inconsistent with respect to degree of difficulty. Some require little to no critical thinking for the junior trainee, others are written with a fastidious attention to detail that may at times fail to underscore the key concepts.Cased-based Anesthesia: Clinical Learning Guides is altogether a welcoming text that should play an adjunctive role in one's library. It does not discriminate among its audience with respect to experience and training. It may, therefore, be useful to the junior-most trainee and to the seasoned authority alike. A most productive use of its contents will entail a focused attempt to answer the open-ended questions before reading the discussion. This may be particularly useful for clinicians preparing for oral board examination. Lastly, the young physician-educator may find himself/herself in need of a basic construct and content for intraoperative teaching. They should expect a thoroughly functional gain from having this text handy for “on the spot” didactics. In summary, Cased-based Anesthesia: Clinical Learning Guides may not yet deserve cardinal shelf space in one's bibliographic arsenal, but those who seek a departure from the density of conventional clinically oriented textbooks in favor of invitingly readable content should expect to be thoroughly satisfied.Northwestern University Feinberg School of Medicine, Chicago, Illinois. n-nathan@northwestern.edu