Despite the importance of providing expert anesthesia care to children undergoing neurosurgery, few resources exist that are devoted solely to this subject. Dr Hemanshu Prabhakar’s book, “Paediatric Neuroanaesthesia,” published by Oxford University Press, adds to the literature and is a comprehensive text on the subject. The book provides a detailed picture of neurosurgical conditions that a pediatric anesthesiologist may encounter. A major advantage of this textbook is its comprehensiveness. The book is divided into 11 sections, starting with the basics, such as neuroanatomy, neurophysiology, neuropharmacology, and preanesthetic evaluation. Specific types of lesions, monitoring and diagnosis, radiology, and special considerations are then covered. The section on neurosurgery is particularly useful for anesthesiologists. Many anesthesiology residency programs dedicate only a few months to specific neuroanesthesia training, which may not include formalized teaching on the distinctions between neurosurgical procedures. For each chapter in this section, a detailed explanation of characteristic pediatric neurosurgical lesions is organized in a formalized, easy-to-follow structure, including sections on anatomy and comprehensive pathophysiology. The authors continue with a brief introduction to each lesion and then a description of the specific perioperative anesthetic considerations. The authors emphasize both the pathogenesis of each condition and its implications for anesthetic management. The concise descriptions of surgical procedures and explanation of anesthetic techniques make the chapters in this section useful for practicing clinicians, teaching faculty, and residents who do not often encounter neurosurgical procedures. Another particularly useful section was “Clinical Procedures.” Most anesthesia textbooks do not give detailed descriptions on how to perform anesthetic procedures, because many of these concepts are naturally taught in the operating room. The authors of this textbook describe common operative room procedures, such as central venous cannulation and arterial cannulation. They also focus on specific neuroanesthesia procedures, such as lumbar drain and intracranial pressure catheter insertion. The chapters describe not only the indication for each procedure but also briefly describe the technique to perform each procedure. Patient positioning, equipment, and tables with a description of equipment specifics are provided. Postprocedure care and complications are also described. This section is helpful for clinicians who are supervising junior physicians through procedures and serves as a great resource for quick refreshers on procedures that are not performed on a daily basis. An outstanding feature of this book is its abundant and numerous tables placed throughout, which assist with making this book a practical resource for the day-to-day management of patients. These tables help with understanding and rapid referencing. For example, a list of abbreviations, placed at the beginning of the book, assists with overall comprehension, as do its relatively larger print size and ample white space. For example, Tables 20.4 and 20.5 are especially useful for a quick reminder about common congenital cardiac defects and clinical concerns relevant to specific heart defects during neurosurgical procedures. Similarly, IV fluid management is of utmost important in neurosurgery. Table 24.2 lists common IV fluids and their unique properties. The composition of various IV fluids with regard to osmolality and individual electrolytes makes this table a convenient reference for deciding which fluid would best suit each individual patient. Figures, in color, were placed in an inset in the center of the book on photo paper. Although the text is clearly written, awkward phrasing throughout many chapters does detract from its overall quality, specifically an absence of conjunctions in many places. A free DVD is included as a complementary resource with every print version. The DVD has visual guidance for 5 common anesthetic procedures, including venous cannulation, arterial and central venous placement, lumbar drain insertion, and performing a tracheostomy. The videos are short and concise, with captions on the bottom providing step-by-step instruction as to how to perform each procedure. These videos are excellent adjuncts for teachers to assist with instruction for difficult procedures. For individuals who are unfamiliar with these particular procedures, these videos provide a valuable reference to help memorize the steps of each procedure. Paediatric Neuroanaesthesia is a worthwhile resource for both pediatric anesthesiologists and general and neurosurgical anesthesiologists taking care of patients with childhood neurosurgical diseases. Aisha Sozzer, MDAnna Clebone, MDDepartment of Anesthesia and Critical CareUniversity of ChicagoChicago, Illinois[email protected]
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Open Access
Dec 31, 2023
Sun Woo Jang + 5
