Anesthesia Secrets

As a student of anesthesia, I often find myself browsing the local medical bookstore for new and informative anesthesia texts; texts that are not only concise in the review of subject matter, but that also offer the advantage of being pleasurable to read. In December of 1995, while studying for my preparatory oral exams, I overheard a few ofmy colleagues discussing a new anesthesia text, a text that they described as "astonishing." After approximately five minutes of listening to them I decided to interrupt and ask the name of this new publication. To my surprise, they mentioned Anesthesia Secrets, part of a series I admired as a medical clerk. This text, like all of its counterparts, is designed to be a question and answer book. Its broad and well-referenced table of contents covers issues pertaining to the basics of patient management through and including statistical and critical analysis of literature, topics that provide the student and beginning trainee with introductory information that is essential to the practice of anesthesia intraoperatively, perioperatively and in the critical care setting. It reinforces the importance of anesthesiologists as physicians and not just mere technicians by systematically covering multiple disease processes and the impact on an anesthetic plan. The greatest strength of this text is the clear, easily understood descriptions of physiology and pharmacology. The chapters on local anesthetics, opioids, neuromuscular blocking agents, inotropes and vasoactive drugs, and the preoperative evaluation are excellent. The chapters on ischemic heart disease and myocardial infarction, and malignant hyperthermia are of particular interest, for they offer the reader concise and easily understandable methods for dealing with these disease states perioperatively and intraoperatively. Discussions of the care of patients with congestive heart failure, valvular heart disease, reactive airway disease, aspiration, obesity, and anesthesia for trauma are outstanding. Other interesting chapters include those dealing with hypoxemia and pulmonary physiology, hypercarbia, hypotension, hypertension, awareness during anesthesia and artificial pacemakers. The chapters on the anesthesia machine, anesthesia circuits, anesthesia ventilators, vaporizers and infusion devices are adequate. The section on regional anesthesia was the weakest in the text. It offers a very superficial approach to regional anesthesia, often forgetting that the primary goal of such chapters is to allow the reader the opportunity to better perform such anesthetic techniques. It lacks a full understanding of the physiology of regional anesthesia, especially the mechanisms behind how intrathecal and epidural narcotics function; an area most important to those anesthesiologists that primarily perform regional anesthesia. Whether the reader has an anesthesiology, surgery, internal medicine or critical care medicine background, this volume will function nicely as an accessible reference. This reviewer strongly recommends this book to practicing anesthesiologists for its completeness, its legibility and its content. Residents utilizing this text will find it most helpful when it comes time to prepare for the oral and written boards.