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Wall and Melzack’s Textbook of Pain, 5^th Edition

Stephen B. McMahon, Martin Koltzenburg (Eds). Elsevier Churchill Livingstone, 2005. $397. 1239 pages. ISBN 0443072876

University of Alberta, Edmonton, Canada

There is perhaps no area of anesthesiology in which good textbooks are more needed than in the study of pain and its treatment. This iteration of one of the two standards in the field does the new editors great credit. It is comprehensive, readable and beautifully illustrated. The input of about 100 worldwide contributors has been meticulously coordinated. The basic science student will find all important extant knowledge about the structural and functional aspects of the pain experience laid out in easily digestible chapters. While the clinical trainee will find this to be a good resource for reading around new cases, the clinical chapters are weaker than the scientific ones. The admonition to use immobilization as part of the primary treatment of complex regional pain syndrome for example, will raise eyebrows, even coming as it does from an acknowledged expert in the area. An obstetric anesthesiologist will find little of interest in the chapter devoted to this specialty. Chronic pelvic pain is reviewed somewhat superficially in just three paragraphs, and perioperative patient-controlled analgesia and radiofrequency neurotomy are hardly mentioned at all.

An exciting additional feature of this latest addition is access to the online version of the full text and illustrations. The editors promise regular updating, and two or three updates have been posted each month since the book’s publication. However, discussion of what I chose as a sentinel topic (the use of COX-2 inhibitors in cardiovascular disease) is out of date in the print version, and has yet to be updated online.

Despite the few limitations, this latest edition of Wall and Melzack’s Textbook of Pain is an excellent text, which should find its way onto the bookshelves of all places where pain is studied and treated.

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