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Obstetric Anesthesia Handbook, Fourth Edition

Datta Sanjay. Springer, NY, USA. 2006, 409 pages. $49.95 US. ISBN 978-0387-26075-4

Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Canada

This fourth edition of the well known Obstetric Anesthesia Handbook is well updated and easy to read. The 17 chapters of the previous edition are retained. Of particular interest in the Fourth Edition, is the manner in which the physiology and pathophysiology of pregnancy and childbirth are reviewed. The topics of maternal physiological changes during pregnancy, labour and the postpartum period, as well as the physiology of labour and delivery are lucidly presented. Review of these considerations progresses to a thoroughly updated review of the approaches to analgesia and anesthesia for relief of labour pain; for Cesarean delivery; for high-risk pregnancy; and anesthesia for surgery during pregnancy. Also included in this latest Edition are trends in neonatal resuscitation practice patterns and maternal mortality and morbidity data from the United States. Pathologies such as coagulopathy in obstetrics are presented in light of current information. Acute hemodilution, cell saver techniques, and selective arterial embolization to control obstetrical hemorrhages are all covered adequately.

With regard to peripartum pharmacology, the chapters on drug interactions and obstetrics; spinal opioids in obstetrics, and the effect of maternally administered anesthetics and analgesics on neonates and neurobehavioural testing offer practical information. Considerations for new drugs, new indications, and new pathologies are introduced. For example, the obstetrical applications of remifentanil, sevoflurane, desflurane and spinal opioids are reviewed, while current approaches to continuous spinal anesthesia in the event of dural tap is discussed.

Readers will appreciate the many practical illustrations and tables indicating drug doses, and comparing techniques. A synthesis of current approaches to many specific obstetrical situations is supported by the inclusion of current ASA guidelines for regional anesthesia in obstetrics, practice guidelines for obstetrical anesthesia from the ASA task force on obstetrical anesthesia, and the ASA optimal goals for anesthesia care in obstetrics. These additional materials provide the reader with a single reference source to check very easily on the evidence and appropriateness of specific anesthetic plans.

In summary, fundamental principles, and most of the new considerations in obstetrical anesthesia are considered in this handbook, and every chapter provides a comprehensive bibliography. Single authorship provides a distinct advantage of avoiding duplication of information or overlap between chapters, so commonly send with multi-authored medical textbooks. The Obstetric Anesthesia Handbook; Fourth Edition, is well updated and provides expert opinion on many clinical aspects of anesthesia for obstetrics which will be very useful for residents in anesthesiology and anesthesiologists involved in obstetrics, when the clinical situation does not allow time to consult more extensive references.

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