The Year in Anaesthesia and Critical Care, vol. 1.

Abstract

The Year in Anaesthesia and Critical Care, vol. 1. Hunter J, Cook T, Priebe H-J, Struys M, eds. Oxford, UK: Clinical Publishing, 2005. ISBN 1-904392-47-4. 432 pages, $119.95. The editors of have recruited an international panel of anesthesiologists and intensivists to contribute to The Year in Anaesthesia and Critical Care which is divided into four parts: perioperative care, clinical pharmacology, and technological advances in anesthesia and in critical care. Each part begins with a brief overview by an editor and this is followed by four chapters that deal specifically with key topics of interest that have occurred in the past year. In each chapter, the subject matter expert presents a few notable publications, reviews, and comments on the important findings of these published papers. Part I covers perioperative care and reviews articles in the following areas: perioperative intravenous fluid transfusion, perioperative blood transfusion therapy, off-pump coronary artery bypass surgery, and protecting the heart in noncardiac surgery. Of particular interest to anesthesiologists, the first two chapters question some of our deep-rooted practices regarding the administration of intravenous fluids and blood products in the operating room. With advancing age of surgical patients and an associated increase in patients with coronary artery disease, the last chapter on protecting the heart in noncardiac surgery reviewed interesting publications that focus on cardiac preconditioning, myocardial protection, and prevention of myocardial ischemia preoperatively. Part II deals with clinical pharmacology and examines new hypnotics, new analgesics, pharmacogenetics and anesthesia, and clinical applications of pharmacokinetics and pharmacodynamics. The search for a propofol formulation with a better pharmacokinetic and pharmacodynamic profile continues, but results are disappointing thus far. Gabapentin and pregabalin have been used in epilepsy and chronic pain treatment and are now being investigated extensively for a role in the perioperative period in the multimodal management of pain. The interest in this area is certainly going to grow. Part III titled “Monitoring and Equipment” is divided into 1) less invasive cardiac output monitoring, 2) depth of anesthesia monitoring, 3) new airway equipment, and 4) ultrasound techniques for central venous access and regional anesthesia. A number of studies have described the use of various less invasive alternatives to a pulmonary artery catheter for measuring cardiac output. In Part IV, these less invasive cardiac output monitors were again compared in a number of trials with PAC. These studies suggest that there are good correlations in cardiac output variables between these two techniques. Advocates for ultrasonography have a strong case for its use in performing central vein cannulation and in nerve blocks. A number of quoted publications have demonstrated both cost-effectiveness and lower risk of complications. In Part IV, studies exploring the choice of resuscitation fluid and the importance of strict glucose control in the critically ill were presented. Anesthesiologists with a special interest in intensive care will find the chapters on non-invasive ventilation and brain death an informative read. The book ends with a complete and easy-to-read index for general search and for searching papers quoted in the book. This is an excellent book that highlights some of the controversial topics in the field of anesthesia and intensive care in 2004. There is no attempt to be a comprehensive, but it does provide busy clinicians with an overview of many significant and original publications. The reader is also guided to various good quality published review articles in the past year. An expert in that particular field comments on all published papers described, and an editor provides an unbiased synopsis and conclusion. For the inquisitive reader, the papers are well referenced so that one can look up these publications for an in depth analysis of the topic. It is unclear how articles were selected. Presumably, there is certain degree of subjectivity and judgment by the contributors and editors. There is also some degree of overlap between the overview for each chapter provided by the editors and the comments by individual contributors. Overall, the editors have achieved what they set out to do. This book is easy to read and a great opportunity for busy anesthesiologists and residents to keep up to date with the most recent development in the selected areas in anesthesia and critical care. Kok-Yuen Ho, MB, BS, MMED Pain Faculty Fellow Tong J Gan, MB, FRCA, FFARCSI Professor and Vice Chairman Department of Anesthesiology Duke University Medical Center Durham, NC [email protected]