This Article Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Girard, F. Search for Related Content PubMed Articles by Girard, F.

Fundamental Principles and Practice of Anaesthesia

Peter Hutton, Griselda Cooper, Francis M. James III, John Butterworth. Taylor & Francis Books Ltd, 2002, 1100 pages. 95.00 UK. ISBN 1-899066-57-8

Montréal Québec

Fundamental Principles and Practice of Anaesthesia is a basic textbook co-edited by anesthesiologists from the United Kingdom and the United States. The book is not really a condensed anesthesia textbook, nor is it a full version textbook, but rather something in between. It is an amalgam of scientific information that can be found in regular anesthesia textbooks as well as in basic science and intensive care texts. The justification for a new textbook in the anesthesiology armamentarium is presented in the foreword and is to provide a novel approach for written information aimed at the early years of training.

The book is bulky (1100 pages), and the glossy paper makes it difficult to read due to light reflection. The printing is monotone with the numerous tables and graphics exclusively printed on a purple background.

Although the editors claim that contributors come from both sides of the Atlantic, Canadian participation is remarkably absent. This textbook (the first page of which is filled with errata), is divided in four sections.

Section 1 - Basic anesthesia practice

The quality of the 17 chapters falling into this section runs from very well done to almost useless. For example, chapters one to five, that interestingly follow the natural sequence of anesthesia from preop to postop, are in reality a compendium of advice that an anesthesiology resident will learn in his first week of training in the operating room. The following chapters (six and seven) on airway anatomy and management are very detailed and appropriate, including an up to date ASA difficult airway algorithm. Chapter eight on equipment is good, but chapter nine (breathing circuit) puts too much emphasis on the Mapleson classification that is really, in my opinion, a part of anesthesia history. In the chapter devoted to monitoring, so much attention is given to the anesthesiologists’ basic senses (touch, hearing, etc.) that little room is left to appropriately discuss pulse oximetry for example. Chapter 13 (unexpected events) covers in only 12 pages a wide variety of critical events from anaphylactic reactions to malignant hyperthermia; curiously the "ACLS" algorithm found in this chapter is so limited that no mention of a specific medication is made. Chapter 15 on regional anesthesia, with the exception of neuraxial block, is completely silent about lower limb conduction anesthesia. Surgical requirements of anesthesia in chapter 16 is incomplete and presents only some aspects of the surgical pathology important for an anesthesiologist.

Section 2 - Integrated basic science

In this section the authors are covering in each chapter an extremely wide range of topics from very basic science to purely clinical matters. Some chapters in this section would best fit in the first section (induction agents, inhalational anesthetics, local anesthetics, etc.). Chapter 18 contains 40 pages covering topics from atomic number to genetics and is of little use for the anesthesiology resident. Chapter 22 on the physiology and pharmacology of the central nervous system is superficial and incomplete (mis-)stating for example that halogenated agents are exclusive cerebral vasodilators. The rest of the section, dealing with pharmacology and physiology is generally complete and well written.

Section 3 - The presenting patient

This is an original section dealing with coexisting diseases, but important information is sometimes lacking. Chapter 47, the patient with an abnormal electrocardiogram, covers essentially the cardiac dysrythmias but is silent for example about pacemakers with integrated defibrillators which poses a special challenge to the anesthesiologist. The following chapter on patients with ischemic heart disease makes no mention of the guidelines for perioperative cardiovascular evaluation for non cardiac surgery published in Circulation back in 1996, a subject of utmost importance for the resident in his first years of training.

Section 4 - Special subjects: physiology and pharmacology

This section is really a misnomer, 14 chapters out of 21 have nothing to do with physiology and pharmacology (arterial cannulation, hazards of laparoscopy, porphyria, etc). It is in reality a melting pot of the remaining subjects related or not (adhesion molecules, endothelium) to the early years of anesthesiology training.

In conclusion, this new basic textbook is not a very useful addition to the existing anesthesiology literature. For the anesthesiology resident, I would suggest the standard general anesthesia textbooks that are far more complete and referenced. At 95.00 UK pounds (roughly $230.00 CAN at the current rate exchange), this textbook is an expensive solution to a non-existing problem.

This Article Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Girard, F. Search for Related Content PubMed Articles by Girard, F.