Awareness During Anesthesia M. M. Ghoneim (ed.) Butterworth-Heinemann; Oxford, UK, 2001, 181 pp ISBN: 0-7506-7201-3; Price £40.00 This is the first definitive book on awareness during anaesthesia edited by the world's foremost expert on the subject. The other 12 contributors hail from the disciplines of anaesthesiology, psychology, medicine and obstetrics, and are top authorities in their fields. The book comprises nine chapters covering all aspects of awareness during anaesthesia - implicit and explicit memory, learning, monitoring (BIS, auditory-evoked responses, isolated forearm techniques), and psychological and medicolegal consequences. It starts with a long Preface that could probably be renamed as the summary of the book. The first two chapters are the heaviest part, accounting for more than one-third of the publication. They deal with the history, concepts and clinical aspects of implicit and explicit recall during anaesthesia. For those who have followed Ghoneim's previous reviews of the subject, these two chapters should be welcomed because they contain more updated information and are organized in a very logical order. Four chapters summarize the currently available techniques for monitoring the depth of anaesthesia. All the advanced tools, including the isolated forearm technique, bispectral index and auditory-evoked potential monitoring, are described in detail. The review on 'Learning during sedation, anesthesia and surgery' is particularly interesting. Of note, Andrade's hypothesis on the relationship between plasma catecholamine concentrations and the probability of learning during anaesthesia will certainly stimulate lots of interest. The chapter on the psychological consequences of intraoperative awareness is illustrated with lively case studies (as is also the case in the other chapters), and is very helpful in describing the scope of the problem. The final chapter presents balanced views from both sides of the Atlantic on the medico-legal issues of intraoperative awareness. On the one hand, all the chapters can be read independently of one another. On the other hand, there has been much repetition of material. Furthermore, the terminology used is not necessarily consistent among chapters. Overall, the book has accomplished its aim of providing a succinct and up-to-date review of the subject. It will become a valuable resource for researchers starting in this field. Clinicians, lawyers and patients will also find it an excellent reference. As more data on intraoperative awareness will undoubtedly become available in the near future, the next edition is eagerly awaited. A. M.-H. Ho M. T. V. Chan Hong Kong, SAR