Textbook of Regional Anesthesia and Acute Pain Management

A. Hadzic The McGraw Hill Company , December 2006 , ISBN 978-0-07-144906-9 , 1259 pp., Price £100.00; US$200.00 This textbook comes from the well-established ‘New York School of Regional Anesthesia’. Now, claiming to be the first reference textbook for regional anaesthesia (RA), its colourful layout and extensive illustrations provide a comprehensive coverage of all aspects related to regional anesthesia. The contributors come from all over the world and show a wealth of experience in their respective chapters. The book is presented as parts that are divided into sections, which in turn contain chapters. Layout is very impressive with each part having colour-coded pages, each chapter beginning with a content box and the text containing colour-coded tabular columns that reminds the reader of an undergraduate textbook. The vital aspects of nerve blocks and local anaesthetics are frequently tabulated for quick reference. ‘Clinical pearls’, boxes that contain a clinical tip relevant to the topic, are a good aide-memoire. There are 14 parts with 83 chapters in total. Like most anaesthesia textbooks it starts with notes on ‘history of local anaesthesia’, followed by ‘foundations of regional anaesthesia’ which contain sections on anatomy including embryology and histology, and pharmacology. The latter covers, in addition to the routine, a chapter on analgesic adjuvants and sedation for regional anaesthesia. The authors are to be praised for the ample anatomical dissection pictures, which greatly help to visualise complex perineural relationships. Part three is the core of the book, which caters to the actual ‘clinical practice of regional anaesthesia’, and covers all the possible central and peripheral nerve blocks that are performed. In addition, it has chapters on local anaesthesia for tracheal intubation, local and RA for eye surgery, oral and maxillofacial RA and intravenous regional anaesthesia. A chapter on motor responses and dermatomes helps to correlate the relationship between nerves blocked and dermatomes anaesthetised. For each block there are colour sketch diagrams, followed by photographs with morphing to show underlying anatomy, photographs showing surface anatomy, some showing the actual technique and further pictures to depict dermatomal distribution and motor responses. The authors have taken pains to add as many clinical photographs of actual patients and high quality illustrations as possible, which make this book, stand apart from other RA textbooks. Parts four and five elaborate on emerging concepts in peripheral nerve blocks such as percutaneous electrode guidance, continuous peripheral nerve blocks and ultrasound for regional anaesthesia. There is also a chapter on ultrasound-guided nerve blocks for children. The subsequent sections, which go to make this book unique, cover RA in various specialties such as obstetrics, paediatrics, geriatrics, patients with systemic disease, pre-existing neurological disease, outpatients and community practice, the emergency department and the critically ill to name the most common groups. Obstetric RA spans a broad range from physiological changes in pregnancy to RA in complicated pregnancy. The section on RA for paediatrics has been written in detail, and includes a chapter on pain management for children. The section on neurological complications and use of RA in patients on anticoagulants is particularly well-written. There is also a section which considers the evidence-based practice in RA that is to be welcomed. The book describes various aspects of acute pain management, including specific protocols and setting up of an acute pain service. Last but not least, it is nice to have a section dedicated to documentation, training and statistics. The prototype documentation forms will be new to many NHS Trusts. Overall, the book aims to cover all aspects of regional anaesthesia. Noteworthy features of the book are the plentiful illustrations and tabular format. The cadaver dissection photos save the reader from buying another atlas. After a long wait, it does fulfil the need for a reference textbook and doubles up as a practical guide for RA. The bibliography is extensive and useful for tracing related articles. On the down side, it is heavy, and therefore difficult to carry around to really be a ‘hands-on’ guide. The publishers have not released a CD-ROM to go with the book, which would have been very helpful. The website http://www.nysora.com fulfills this to a large extent. Is the book worth buying? It certainly is for trainees wanting to pursue further training in RA. It is also a valuable addition for consultants who routinely practice RA. It is a must for the departmental library although a novice trainee may benefit from a smaller textbook to start with.

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