Epidurals for Childbirth (2nd edition)

Abstract

May, A. & Leighton, R. Cambridge University Press , ISBN 9780521704618 , 202 pp ., Price £24.99 (US$48.00) Anne May and her colleague Ralph Leighton are both consultant obstetric anaesthetists at The University Hospitals of Leicester with many years of experience between them. Dr May, in addition, has been President of the Obstetric Anaesthetists’ Association (OAA) and also a Member of Council at the Royal College of Anaesthetists. A foreword is provided by Steve Yentis, which illustrates the great affection and respect held for Dr May in obstetric anaesthetic circles. Now in its second edition, having first been published in 1994, this very popular book has been thoroughly revised and updated. The aim from its inception has always been to target a wide audience of the healthcare professionals involved in the provision of obstetric epidural analgesia and anaesthesia. Despite the broad appeal of this book much of the information here is highly relevant for anaesthetists of all grades and is of the type commonly asked in both parts of the Fellowship examination. The text of the book is logically laid out and easily accessible, with illustrations where required. The broad structure of the 13 chapters can be divided into six general sections: Information relevant to mothers and the consent process for epidurals. Theoretical knowledge including relevant anatomy and physiology. Practical guidance in the insertion and management of epidurals. The complications associated with epidurals and appropriate treatment options. Regional blockade for lower segment Caesarean section. Running an obstetric anaesthetic service – systems, risk and record keeping. At the end of the book are nine appendices containing reproductions of some of the OAA’s advice leaflets for expectant mothers, a copy of The National Maternity Record epidural analgesia chart for labour, a copy of the recovery observation chart used at the authors’ hospital and a comprehensive guide to further reading including web based information. This book has much to commend it. Just as in the first edition the authors offer down-to-earth, evidence based and practical advice. The latter chapters on the management of women with abnormal obstetric and concurrent medical problems respectively provide a to-the-point summary of these important topics, while carefully avoiding irrelevances that usually pad out weightier tomes. There is unfortunately an error in two of the diagrams (figs 3.4 and 4.2), where the lumbar vertebrae are labelled in reverse order, one or two spelling errors, and it is probably a reflection on local Leicester practice that there is no mention of the alkalinisation of lidocaine with bicarbonate for Caesarean section epidural top-up. However proof-reading errors and minor omissions aside, this book represents excellent value for money, is a genuinely accessible introduction to the subject and would make a valuable addition to any personal book collection or anaesthetic library.