Textbook of Regional Anesthesia

Abstract

Textbook of Regional Anesthesia P.P. Raj, editor. New York: Churchill Livingstone, 2002. ISBN 0-443-06569-1. 1104 pp, $195.00. Science is organized knowledge.—Immanuel Kant (1724–1804) With his Textbook of Regional Anesthesia, P.P. Raj has attempted to “provide updated content in this field to all clinicians.” To a large extent, the metamorphosis from, and complement to, his other texts and handbook on regional anesthesia and pain medicine, has succeeded. Through the assistance of 10 internationally respected section editors, a roster of new and seasoned authors has organized the expanding science of regional anesthesia into 54 readable chapters. The chapters are divided into eight sections, which provide the scope of the text: Development of Regional Anesthesia, General Considerations for Regional Anesthesia, Basic and Clinical Researches in Regional Anesthesia, Clinical Practice of Regional Anesthesia, Advanced Interventional Techniques in Regional Anesthesia, Complication of Regional Anesthesia, Outcome Studies in Regional Anesthesia: Evidence-Based Practice, and Future Trends in Regional Anesthesia. At an average length of 10 to 15 pages, the chapters are succinctly written but readable to the clinician desiring either quick preprocedure review or a deeper understanding of the subtleties. Certain chapters are welcome additions to the traditional regional anesthesia text, including those on “Untreated pain and its cost to society,” “The practice of regional anesthesia in developing countries,” and “The training and education of a physician for regional anesthesia.” In addition, despite the use of multiple authors, the writing is clear, consistent, and well researched. A wonderful strength permeating throughout is the reflection on the ideas and investigations leading to the current techniques and methodologies. Moreover, the text successfully communicates the three-dimensional practice of regional anesthesia into understandable concepts. This is done through the frequent use of exceptional photographs (such as the microphotographs of the dural, pia, arachnoid fibers in chapter 19), diagrams on anatomic landmarks, nerve and needle locations (e.g., chapter 20), and clinical algorithm flow charts (e.g., chapter 27). Some alterations may improve future editions of this text. Owing to the application of similar techniques to different clinical situations, the text can be repetitive at times. This is particularly noticeable with the section on “outcome studies,” which comments on literature cited in previous, often similarly titled, chapters (e.g. Obstetrics, Trauma, and Malignant Pain). This being said, the glimpse from different vantage points can only help the reader appreciate the subtleties contained within the data and bolster understanding. In addition, while the chapters concerning the organization of acute, chronic, and palliative pain services are necessary and beneficial, a more practical approach, such as that used in the chapter on “organization of nerve block facilities” could be adopted to assist the practicing clinician more. Such chapters could more readily answer frequently asked questions regarding the establishment, staffing, and protocols used with such services. Overall, The Textbook of Regional Anesthesia successfully captures the essence, modalities, and techniques currently advancing the field of regional anesthesia and would be of great value to both the novice and learned anesthesiologist. Dr. Raj has succeeded in creating a text that organizes the latest information to those interested in understanding, providing, and contributing to the science and art of regional anesthesia.