Case-Based Anesthesia: Clinical Learning Guides

Abstract

This textbook of 60 clinically based chapters aims to appeal to a broad readership: few anaesthetists would exclude themselves from the ‘ … international array of inquisitive trainees and clinicians whose basic goal is safe and unsurpassed clinical care … ’, as described in the Foreword section. It hopes to encourage learning through presentation and discussion of clinical cases, with consideration of current evidence, culminating in ‘Key Messages’. The aim is to provide material that supports continuing learning for all anaesthetists, irrespective of their level of experience. The target audience is certainly not limited only to those in training, and a broad range of topics is covered. Despite the large number of contributors, each chapter follows the preset pattern, making it an accessible, well-referenced book. The range of topics is broad, including perioperative statin use, off-pump cardiac surgery, muscular dystrophies, complications of neuraxial blockade, mitochondrial disease, and awareness, to name a few. It is more likely, perhaps, to appeal to general anaesthetists and trainees, rather than to those working in the subspecialities. Many of the contributors are US-based, with several others working, not surprisingly, in Cork, Ireland (the home of at least two of the editors). A US-style of practice is occasionally apparent, although not such as to undermine its broader relevance. Abdominal paracentesis in trauma, pulmonary artery catheters in bariatric surgery, and use of aprotinin are such examples. In some instances, the summary of a topic in its ‘Key Messages’ brings more simplification than may be intended in the text. For example, in the chapter on perioperative β-blockade, the current evidence is reviewed well and recognizes the increasingly cautious approach to perioperative β-blockade, yet the Key Messages appear to advocate a more wholehearted use. Topical issues are addressed, such as sugammadex, hypertonic saline, and cuffed tracheal tubes in paediatrics. There are particularly good chapters dealing with Duchenne muscular dystrophy, mitochondrial disease, and vasopressin. The format of each chapter being only three or four pages is sometimes a limitation. For example, more detail on anaesthesia for MRI would have been appreciated by this reviewer. This format does, however, work well overall, allowing an engaging overview in most cases. Indeed, a comprehensive series of cases is examined in this book. Should trainees, and those no longer in training, buy this book? Although well-written and broad, it is quite expensive. It seems unlikely that it will replace any of the current exam-focused books in widespread use in the UK, but this is probably not the authors' aim. The chapters are easier to read than many review articles, and so provide an introduction to lots of topics, making it an enjoyable book. However, many would probably derive similar benefits from editorials and review articles in peer-review journals and educational supplements. This book is a pleasant and novel adjunct to learning which will prove to be of some interest to all clinicians, particularly those looking for a fresh resource to aid their learning.