Oxford American Handbook of Anesthesiology

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Mayo Clinic Rochester, Rochester, Minnesota. shakespeare.william@mayo.eduOxford American Handbook of Anesthesiology By Patrick M. McQuillan, M.D., Keith G. Allman, M.D., and Iain H. Wilson, M.D. New York, Oxford University Press, 2008. Pages: 1194. Price: $39.95.A pocket manual is a trainee’s right hand. I picked up a copy of the Oxford American Handbook of Anesthesiology at a time in my residency when I needed a condensed text to help me navigate rigorous surgical specialty rotations and found the manual to be a well-conceived, concise handbook. While not an exhaustive source, it is lengthy enough to provide summative information on a broad range of anesthesia topics, but at the same time it is portable enough to have within reach when a quick quandary arises.Starting into my introductory clerkships in pediatric and cardiac anesthesiology, I already had a copy of Ezekiel’s Handbook of Anesthesiology 1that I had purchased for $17 the week before starting residency. Now, 17 months later, the book was speckled with marginalia, taped twice down the spine with surgical tape, and worn from being as integral to my operating room day as a stethoscope. Starting into my subspecialty anesthesia rotations and in anticipation of the annual anesthesia in training exam, I left Ezekiel in the locker and adopted the more voluminous Oxford text, anticipating a more in-depth resource for specialty knowledge and broad review.The Oxford Handbook required some logistic adjustment. Too thick to occupy Ezekiel’s spot in the back pocket of my scrubs, the book rested instead on the anesthesia machine for reading between cases. On call, it stayed in the call room for consultation instead of in my white coat pocket. It has proven to be what it claims: not a pocket book, but a handbook—a concise reference that is easier to tote than the tomes by Miller or Barash or Morgan2–4but that still covers the practical highlights of these texts. Also, the book may not be structurally suited to outlasting residency training. After a couple of months’ use, the binding had failed, leaving the cover half separated and patched (like my copy of Ezekiel) with its own length of surgical tape.On the whole, the content of the book exceeded my expectations. It approximated the most practical information of much larger texts into succinct points and gave enough detail to be useful board preparation without being encumbered with excessive detail. In a preoperative evaluation of a patient with Takayasu’s Arteritis coming for vascular surgery, I consulted the Oxford Handbook and found the main points that I would have searched out in a much longer read of a much larger text such as Stoelting’s Anesthesia and Coexisting Disease .5It was similarly useful in a pediatric patient with achondroplasia coming for an outpatient procedure. The handbook contains a section summarizing common surgical procedures that reads like a portable equivalent of Jaffe’s Anesthesiologist’s Manual of Surgical Procedures .6In a period of training when I was introduced to procedures ranging from thoracoabdominal aortic aneurysm repairs to electroconvulsive therapy, I found that the synopses on case management reliably prepared me for practical management of the anesthetic and familiarized me with the salient points of relevant physiology. There was one critical gap in the content of the Oxford Handbook that made me wish at times that I still had my Ezekiel manual in my back pocket—the Oxford Handbook doesn’t have a pharmacology and dosage section. It was no help when I grabbed the text looking for the milligram per kilogram dosage of clindamycin for a pediatric patient, or titration parameters for dexmedetomidine, or alprostadil. This omission is the only categorical flaw I found in the text. Any other answers I didn’t find in its pages were perhaps unreasonable to expect from a handbook—no details on the analysis of thromboelastograms, for instance.Doctors McQuillan, Allman, and Wilson have assembled an excellent resource for the anesthesia trainee that has much to offer to even experienced providers. The section on anesthetic risk, for instance, provides a very palatable format for expressing the risks of anesthesia to patients in lay terms, such as the probability of winning the lottery or experiencing a mishap in traffic. The handbook is an impressively condensed, useful resource that offers high-yield information from a much larger library in a single volume that totes easily into the operating room.Mayo Clinic Rochester, Rochester, Minnesota. shakespeare.william@mayo.edu