Gastrointestinal and Colorectal Anesthesia

Abstract

The book consists of 27 chapters by a total of 43 authors, mainly from the UK but several from the USA and Scandinavia. The book can be roughly split into three sections: the first eight chapters deal with general considerations, then 16 chapters on specific operation types, and the final three address postoperative care. Each chapter has a comprehensive reference list. The stated aim of this book is to bring together material on gastro-intestinal (GI) surgery and anaesthesia to provide a scientific and clinical basis for anaesthetic practice. The first section has chapters on: GI physiology, surgical considerations for upper and lower GI surgery, the stress response, measurement of outcomes, reducing morbidity after colorectal surgery, preoperative assessment, and preoperative optimization. These chapters all give a good overview of the subject. This section contains useful chapters, written by surgeons, outlining the surgical considerations in upper and lower GI surgery and on reducing morbidity. As successful management of patients, often frail ones, for major GI surgery has to be a team effort, it is important that anaesthetists are aware of the surgical aspects of the case (and, of course, the surgeons of the anaesthetic aspects!). The second section constitutes the bulk of the text and has some general chapters on regional anaesthesia in abdominal surgery, sedation for endoscopy and rapid recovery, and a series of chapters on anaesthesia for specific surgical procedures/sites, including oesophageal, gastric, bariatric, anti-reflux, hepatobiliary, pancreatic, laparoscopic, carcinoid, phaeochromocytoma, colorectal (with a separate chapter on the elderly), anorectal, and emergency laparotomy. These chapters do not follow a rigid structure but all cover preoperative care, anaesthetic techniques, analgesia, and postoperative care. Much of my clinical practice involves anaesthesia for upper GI surgery and I found that all the chapters gave an appropriate coverage to techniques and their selection for an individual patient. The style of writing is clear and each chapter relatively short (average 15 pages) with regular use of tables but few illustrations. The final three chapters deal with postoperative pain, PONV, and critical care. These three chapters cover the full range of problems and options. The critical care chapter raises important issues about the provision of ICU capacity for GI surgery. In general, I think this book succeeds in its stated aim. However, it is relatively expensive. It is an obvious source of information for anaesthetic trainees encountering GI surgery for the first time or when preparing for examinations, but many clinicians involved in anaesthesia for GI surgery will also find it useful. I am a bit puzzled as to why a textbook written by two eminent UK clinicians and with mainly UK authors should use US rather than UK English spelling throughout. That minor irritation apart, I am happy to recommend this book to trainees and departments.