Pain Review.

Abstract

Cleveland Clinic, Cleveland, Ohio. vroomab@ccf.orgPain Review. By Steven D. Waldman, M.D., J.D. Philadelphia, Saunders–Elsevier, 2009. Pages: 780. Price: $79.95.Pain medicine fellows frequently ask for the name of a good reference to read during training or when studying for a pain medicine board examination. Among other prominent names in pain medicine literature, “Waldman” is frequently offered in response. Steven D. Waldman, M.D., J.D., has produced numerous atlases and texts over the past decade and will have three new texts published in 2009 alone, so his name is only a partial answer. Fellows need to know which Waldman to choose. With the publication of Pain Review —his most succinct, well-organized, and practical review book to date—the answer is now quite clear.Pain Review is a durable soft-cover text organized into nine sections of 355 (yes, 355) chapters. These chapters are well written and surprisingly thorough given that some are only one page in length. They are user-friendly, as is the book’s overall structure. Dr. Waldman seems to have followed the American Board of Anesthesiology Pain Medicine Examination Specification Outline in organizing his text into the following sections: Anatomy, Neuroanatomy, Painful Conditions, Diagnostic Testing, Interventional Therapy, Physical and Behavioral Modalities, Pharmacology, Special Patient Populations, and Ethics.Dr. Waldman spends a greater percentage of the review’s pages on procedures than might be necessary for the certification examination (because this only counts for approximately 20% of the examination content), but residents or fellows who have not performed these procedures will certainly be grateful. Many readers will also appreciate the 767 multiple-choice questions and answer key provided.Unlike Dr. Waldman’s other texts, the purchase of Pain Review allows for activation of the Web site expertconsult.com*using an encrypted password. This site is helpful when one is in need of a quick on-line reference from a remote location or a pain clinic. The index feature steers users to several listings of an ilioinguinal nerve block, for example, within the Web site, much as Dr. Ronald D. Miller’s on-line version of Miller’s Anesthesia 1does.Pain Review is the best Waldman book for examination review, but it is not the consummate text for pain medicine residents or fellows. His two-volume Pain Management 2is a more thorough compendium of this field. The critical care and ethics portions of his new text are slightly underserved relative to the approximate 5% each topic is represented in the certification examination. They inherently deserve more attention than is given. Although Pain Review does contain some fluoroscopic images, such as the two-needle and the transaortic celiac plexus block, Waldman’s Atlas of Interventional Pain Management 3is more thorough in this regard.When you have published as much as Dr. Waldman, you run the risk of overexposure. At the end of each chapter, Dr. Waldman offers suggested readings, many of which are his other texts. He cites other helpful reference books, too, but not much in the way of recently published articles in pain medicine or anesthesiology journals. Some readers might also object to how the descriptions of many procedures, such as the sphenopalatine ganglion block or the gasserian ganglion block, are taken verbatim from his Atlas of Interventional Pain Management .2Small oversights are found commonly in Pain Review but do not detract appreciably from its overall value. “Three millimeters of either 2% viscous lidocaine or . . .” on page 391 obviously was meant to be “milliliters.” Figure 28-1 is entitled a “thoracic dermatomal chart” but is a chart of only cervical dermatomes. Figure 30-2 is described as a “T2-weighted MR image” but is actually a fluoroscopic image of a discogram. Regarding the answer key, it would be nice to have written explanations to the answers, though this would have extended the length of the book. In lieu of this, listing the page number where the answer could be gleaned from the reading would have been helpful.Although there is still room for improvement, Pain Review will help many board-eligible and recertifying pain physicians prepare for pain medicine board examinations. It covers the examination topics well and anticipates the needs of pain medicine fellows with a large data bank of practice questions and the useful Internet application.Cleveland Clinic, Cleveland, Ohio. vroomab@ccf.org