Essentials of Neurosurgical Anesthesia & Critical Care

Abstract

The ambitious text, Essentials of Neurosurgical Anesthesia & Critical Care, encompasses the perioperative care of adult and pediatric neurosurgical patients in 14 parts with 91 chapters on 943 pages in paperback format. One hundred fifty-seven international authors contributed to this first edition by Drs. Brambrink and Kirsch. In a multidisciplinay approach, it covers both the anesthetic aspects of neurosurgery and the neurocritical care of neurosurgical patients. The book begins with a well-structured synopsis of the basics of neuroanesthesia including anatomy, neurophysiology, and pathophysiology followed by preoperative assessment, preparation for surgery, and ubiquitous fundamental concerns in neurosurgical anesthesia. Critical situation scenarios during anesthesia for adult brain and spine surgery are discussed in detail in 19 chapters with each scenario or procedure in a dedicated chapter. Basics and specific concerns of pediatric neuroanesthesia are covered in parts 8 to 10. The next 2 parts give a concise description of procedures in interventional neuroradiology and implications for the anesthesiologist. The last 2 sections deal with challenges that may be encountered in the postoperative care of neurosurgical patients in the recovery room or the intensive care unit, and on issues that are most specific to neurocritical care. Each chapter covers 1 neuroanesthetic or neurocritical care issue, whether it is basic science, a specific intervention, or a complication of neurosurgery. The layout is purposeful and clear, and all information is presented in a highly structured way. Repeating this sequence in every single chapter helps the reader’s orientation as we are taken directly from an existing issue to potential clinical solutions. Chapters typically begin with a short introductory overview of the topic followed by discussion on the prevention and crisis management of potential complications. A multitude of tables, flow charts, and high-definition figures, some of them in color, simplify and reinforce the understanding of context and create a smooth reading experience. Key points are highlighted in a gray box toward the end of the chapter, summarizing the most important information for readers, and adding to the utility of the text as a quick reference handbook. Every chapter concludes with a list of suggested reading, citing recent articles from the medical literature. As reviewers, we specifically looked for parts that we felt were missing in other publications of this kind. The presence of a chapter in this book on the interpretation of neurological imaging such as magnetic resonance, brain computed tomography, or cerebral angiography, a must for most neuroanesthesiologists, is a good example of the breadth and usefulness of the book. Two other chapters (12 and 16) are unique: the former discusses the consent and communication issues particular to neurosurgical patients, and the latter deals with the intraoperative teamwork and collaborative care of high-functioning neurosurgery teams. Both chapters were exceptionally well written. One major criticism of this book is the omission of anesthesia for epilepsy surgery in adults. Although there is a chapter on pediatric epilepsy surgery, adult epilepsy surgery still deserves a separate chapter and treatment. Likewise, the use of electroencephalographic monitoring in neurocritical care is omitted from the neurocritical care section. We feel that continuous electroencephalographic monitoring is now routinely being done in many neurocritical care units and needs to be discussed. For anesthesiologists interested in this area, the book is a true page-turner and a pleasant reading experience, and presents a clear underlying philosophy about building bridges. Authorship from leading international clinicians and neuroscientists demonstrates a truly global approach and a representation of common knowledge across geographic boundaries. In the relatively small world of neuroanesthesiology, this selection of international contributors is unequaled and is a good indicator of the enormous effort invested in this book, which succeeds in creating a quality image of the state-of-the-art in neurosurgical anesthesia and critical care practice today. In a practical problem-orientated manner, the book also reminds us of the importance of continuity in patient care from the operating room to the critical care unit as emphasis is brought to the multidisciplinary and collaborative nature of perioperative medicine. While in its first edition, this work has the potential of setting a new benchmark in the neuroanesthesiology literature and was certainly intended as such by Drs. Brambrink and Kirsch. We can highly recommend this book to anyone interested in the specialty of neurosurgical anesthesia and critical care: trainees and faculty in anesthesiology, neurosurgery, and critical care, as well as nurses and nurse anesthetists. Nicolai Goettel, MD, DESA Lashmi Venkatraghavan, MD, FRCA, FRCPC Department of Anesthesia University of Toronto Toronto, Ontario, Canada [email protected]