Clinical Anesthesia Practice, 2nd Edition

Clinical Anesthesia Practice, 2nd Edition Kirby RR, Gravenstein N, Lobato E, Gravenstein JS, editors. Philadelphia: WB Saunders, 2002. ISBN 0-2716-8566-8. 1704 pp, $125.00. In the preface the editors raise the question “why should this book be published?” and acknowledge that it is not encyclopedic. Nevertheless, in 10 sections ranging from “Safer Practice” through “Tools of the Trade” to “Transplantation” and divided into 76 chapters, considerable practical clinical material is presented. The four editors and the 28 authors are from the University of Florida, but the remaining 82 authors represent many institutions, including international contributions from Australia, Canada, Israel, and the United Kingdom. The format employed is unique in that each chapter starts by listing a series of pertinent questions, ranging from 6 (“Critical Incident Management”) to 94 (“Abdominal Surgery”). The questions range from “Why does [the abdominal wall] get tight?” to “What is a ‘snorkel’?” In many chapters, initial questions address “What…?” and later ones address the very important “Why…?” The questions are then answered, depending on their complexity, succinctly in a short paragraph or in an extensive discussion in a series of paragraphs as necessary. The text is well supported with figures, diagrams, tables, and a 93-page index. Although the writing is uniformly good, there is considerable variation in the depth of coverage, which explains the nonencyclopedic comment in the preface. The 44 pages and 84 questions on “Post Anesthesia Recovery” provide a comprehensive review of the subject as does the six-page, six-question review of the “Critical Incident Management.” In contrast the 12 pages and 6 questions on cardiology consultation appear terse. At the other extreme the 14 pages and 18 questions on the “Anesthesia Record” may provide more information than most desire. The failure to list postobstructive pulmonary edema (formerly called negative pressure pulmonary edema) as a cause of noncardiogenic pulmonary edema is a surprising omission in an anesthesia text (page 216). The inclusion of both defense and plaintiff lawyers’ perspective in the chapter on “Medicolegal Issues and Concerns,” somewhat analogous to a Pro-Con debate on some newspaper editorial pages and/or society newsletters, provided a new perspective for this reviewer on this issue. Who should consult this text? Although every clinical anesthesiologist would benefit from its availability, the question-and-answer format may make it especially helpful to candidates preparing for the Board examination, especially the oral portion. Norig Ellison Department of Anesthesia, University of Pennsylvania, Philadelphia, PA

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