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Book Review |
University of Ottawa Heart Institute, University of Ottawa, Ottawa, Canada
This is a truly updated and reformatted major anesthesia textbook in all respects. It has three components: a traditional hardbound textbook (consisting of over 3,200 pages, 1,400 illustrations, and contributions from 156 authors, editors included), a companion video CD-ROM, and a new online version. The textbook (including the CD-ROM) or online version (the Network Edition) may be purchased separately, or together as a package (the E-dition).
This definitive textbook is an asset to the Specialty. In addition to a thorough update of the printed text, the 6th Edition includes both an expanded companion video CD-ROM and a new online version of the complete text. Considering the sheer volume and weight (8 kg) of the text, and the ever-changing information at hand, online access is most welcome.
Authors have significantly updated every chapter, and several new ones have been added. The CDROM, initially introduced in the fifth edition, has been expanded to 11 segments, with additions including code blue simulation, Fastrach intubation, thoracic epidural, ultrasound guided nerve blocks, peripheral venous access, and cricothyroidotomy.
Updated and new chapters
Previous chapters received significant updates including enhanced content, updated references and new formatting. The format includes improved tables and graphs and a ‘key points’ section after the summary of each chapter. Some chapters have been completely rewritten (e.g., History, Acid-Base) while others have new or added authors. Many of the new chapters deserve a brief review:
Chapter 15 - Complementary and alternative therapies
This chapter addresses the significant popular use of herbal medicines and non-herbal dietary supplements, as well the use of acupuncture and music therapy. Discussion includes the effects of echinacea, ephedra, garlic, ginko, ginseng, kava, saw palmetto, St. John’s wart, valerian and others.
Chapter 35 - Implantable cardiac pulse generators: pacemakers and cardiovertor defibrillators
This well organized and practical chapter thoroughly reviews the topic. The chapter outlines a safe basic approach, while the role of increasingly commonplace conduction devices, such as ICD’s and bi-ventricular pacemakers is presented.
Chapter 64 - Chemical and biological warfare agents: the role of the anesthesiologist
This chapter introduces a frightening, but realistic topic to anesthesiologists. It is well referenced for those curious for more information. Myths and realities are clarified. Topics include: nerve agents, vesicants, lung damaging agents, toxins and bacterial biologic agents. Viral agents are not addressed and the reader is advised to seek this information elsewhere.
Chapter 66 - Anesthesia for robotic surgery
Developing technology for minimally invasive surgery and its anesthetic implications are outlined in this section. Current robotic systems are described as well as current and ‘in-development’ applications, including general, thoracic, urologic, gynecologic, neuro and cardiac surgery. The unproven, but anticipated patient-benefits of robotic surgery are mentioned briefly.
Chapter 80 - Medical information on the internet
This section presents a concise overview of internet access to ‘peer-reviewed’ medical information. Optimal use of public sources, especially PubMed and MEDLINE is described. Most of the hyperlinks work.
Chapter 82- Perioperative visual loss
This thankfully rare complication is described in great detail. Prevention, treatment and prognosis are well described. The microvascular anatomy of the eye--although detailed and accurate--could be more concise, as could other aspects of the chapter. It is extensively referenced.
Chapter - Human performance and patient safety
This comprehensive chapter is a highlight of the textbook and should be mandatory reading for all anesthesiologists, trainees or experienced. It could well be a text on its own. It reviews the performance and behaviour of the anesthesiologist in multitasking during complex real-time situations. Descriptions include concepts of spare capacitance, overall alertness, fatigue, and the dynamic domain. Explanations of performance shaping factors are practical and clear.
Companion video CD-ROM
All videos are very good in content and on-screen quality (up to 1024 x 768), including the new additions.
Network edition
Anesthesiologists should seriously consider supplementing the printed text with access to the online version (http://www.anesthesiatext.com/). It provides the complete text, tables and figures, as well as access to the companion CD-ROM videos, a drug database, and dated text updates. Portability comes from any internet access point with a username and password. A search engine (beyond a mere Index) improves its use as a true reference text. References hyperlink to Medline abstracts or full articles and greatly facilitate literature searches on topics of interest. The online Edition also offers the ability to easily download all figures in multiple familiar formats The Editors of the online version aspire to provide frequent text updates, thus creating a ‘living text,’ whereas a paper text becomes inevitably dated once in print. However, those who consider purchasing only the online version should note that online access is available only until the release of the next edition (or a minimum of one year of access). The publisher reserves the right to terminate the online version at any time while sending the purchaser an "equivalent" CD-ROM.
Overall, this is a first class and current work of knowledge and of benefit to all anesthesiologists.
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