Pediatric Anesthesia: Principles and Practice

Abstract

Paediatric anaesthesia has made great advances over the past few years including having its own specialist journal. We now have a completely new textbook of over 1600 pages on this subject to add to our written armamentarium. This publication is a truly multinational collaboration with the two editors, Bruno Bissonnette (hailing from Canada) and Bernard Dalens (from France), and the other 143 contributors representing all continents, except Antarctica. It includes most of the acknowledged experts in the paediatric anaesthetic world. Whilst such a diverse authorship could lead to variations in style, the editors have, on the whole, managed to maintain a consistency to the book, although the constant use of metric rather than SI units is irritating to the European reader. The book is split into six sections, with the first section dealing with both normal and abnormal human development. This includes a chapter on the development and evaluation of pain and the stress response, which is relevant, but the chapter on chronic and recurrent pain in children and adolescents is incongruous in this section. The second and third sections examine pharmacology of anaesthetic and analgesic agents, and anaesthetic management and techniques. This is followed by the section on special monitoring and resuscitation. The penultimate and largest section has the somewhat unwieldy title of ‘Surgical and Anesthetic Considerations of Procedures’. It is this section that will probably be referred to most in this book. For each particular surgical and anaesthetic subspecialty (e.g. cardiac, ophthalmic, neonatal), there are two chapters. The first is by surgeons describing the presentation and surgical management of various conditions. This is then followed by the chapter on the anaesthetic management of these conditions by anaesthetists. In a number of the anaesthetic chapters, the authors have written the typical anaesthetic management of particular conditions in the form of tables, which are very easy to follow, in a stepwise manner: a good example being the chapter on the anaesthetic management of the neonate. As the surgical and anaesthetic sections are written by different authors, there is some avoidable duplication of information. The final section of the book is entitled ‘Future of Pediatric Anesthesia’. The title is somewhat misleading as rather than describing a brave new world of paediatric anaesthesia, it addresses issues such as medicolegal and ethical subjects, education and training, and the use of computers and online services. There are many high quality greyscale illustrations (no colour), throughout the text. However, there is one glaring omission, which is surprising for a book of this size, and more so if it is to become the standard paediatric anaesthetic reference book. There is no section on syndromes and unusual paediatric diseases and their relevance to the anaesthetist. In fact, some conditions that are a particular challenge to paediatric anaesthetists, such as the mucopolysaccharidoses, which cause major airway problems, are not mentioned at all. This seems particularly odd as an advertising flyer for this book asserted that the book would include ‘a convenient, alphabetized section of every acute pediatric syndrome encountered worldwide, listing both precise instructions and quick reference information for each case’. In summary, although this is not a complete reference book, it does provide an excellent summary of current paediatric anaesthetic practice, which should be available in any department where children have anaesthetics.