Regional Anesthesia in Infants, Children, and Adolescents

Abstract

Department of Anesthesiology, West Virginia University Medical Center, Morgantown, West Virginia 26506.James C. Eisenach, M.D., Editor.Regional Anesthesia in Infants, Children, and Adolescents. Edited by Bernard Dalens. Williams & Wilkins Waverly Europe, 1995. Pages: 550. Price:$105.00.Whereas other anesthesia books contain large sections on the topic of pediatric regional anesthesia, Regional Anesthesia in Infants, Children, and Adolescents remains the only textbook currently on the market that is devoted entirely to the subject of pediatric regional anesthesia. The strongest feature of the book is that it is produced by a renowned group of authors who have a vast and broad experience in the use of regional anesthesia techniques in pediatric patients. They have taken the knowledge they have gained from their many protocoled outcomes studies and coupled this information with a thorough review of the world literature, not just the English language literature, to create a commendable piece of work.The translation from French to English by Rita Khandawala is very professional, and leads one to believe that the book was originally written in English. However, the text is not without error, and some of the mistakes are substantial. Legends are reversed in tables, and several drawings, while anatomically correct, are incorrectly labeled. These errors lead this reviewer to suggest that this book may be more useful to the experienced regional anesthetist, who can recognize the errors, and may not be for neophytes just learning pediatric regional anesthesia techniques.Two blocks are synonymous with the Dalens' name, the fascia iliaca technique for neuroblockade of the lumbar plexus and the parascalene approach to blockade of the brachial plexus. It is this reviewer's opinion that these blocks are major and important advances in pediatric regional anesthesia; however, in the original journal articles, the supporting artwork lacked detail, size, and color. These aspects made it very difficult to understand the landmarks and fascial planes inherent to the successful placement of these blocks. Unfortunately, once again, the plates in the textbook lack the size, labeling, and color needed to render them supportive and useful. Two full-color pages would have made a remarkable difference.Perhaps the best single aspect of the book is the wonderful chapter on “Pharmacology” by Isabelle Murat. In just 30 pages, she helps one understand why children obtain dense blocks with dilute local anesthetic solutions such as 0.125% bupivacaine and why neonates are at increased risk of local anesthetic toxicity. This chapter and the authorship by Professor Dalens on the majority of the remaining clinically relevant chapters in the book make it a reasonable buy for $105.00.L. M. Broadman, M.D., Department of Anesthesiology, West Virginia University Medical Center, Morgantown, West Virginia 26506.