Morbid Obesity: Peri-operative Management

e fi rst edition of Morbid Obesity: Peri-operative Manage ment, published in 2005, was heralded as an important and timely comprehensive review of perioperative care of morbidly obese surgical patients. Adrian Alvarez has built on the success of the fi rst book and, with the help of three new editors, has presented a concise and well-written text about the complexities of dealing with morbidly obese surgical patients. In this second edition, the 25 chapters are arranged in fi ve general sections. Th e text is well illustrated and competently organized. Th e authors come from varied clinical backgrounds and include anesthesiologists, surgeons, and intensivists. Each chapter is well researched and appropriately referenced and deals with all aspects of care of bariatric surgical patients. Th e authors start with a discussion of specifi c challenges of the pathophysiology in the bariatric population and then move on to preparation and pre-operative management, intra-operative management, and postoperative care of bariatric surgery patients. Th e text has minimal repetition and fl ows very well from one section to the next. New features in this edition include chapters on the pathophysiology of pneumoperitoneum, postoperative rhabdomyolysis, informed consent, and bariatric surgery in adolescents. Th e chapters on positioning, monitoring, airway manage ment, drug dosing, ventilatory strategies, co morbidities, and post-operative care all include information that would be extremely relevant to the practice of both anesthetists and intensivists. Some chapters (for example, the ones dealing with informed consent, renal dysfunction, and cortical electrical activity monitoring) were informative but did not seem to provide obesityspecifi c information. Although intensivists and anesthetists are not responsible for operative decisions, the authors could have provided greater detail about the selection of bariatric procedures and their associated outcomes and benefi ts. Th e book is an excellent resource for anesthetists, surgeons, and intensivists who wish to develop skills to recognize potential complications and provide quality peri-operative care to obese patients. Th is book will also be valuable to nursing staff , dieticians, and managers involved in the care of morbidly obese patients and will be a useful addition to the reference collection of institutions planning to develop or improve their bariatric surgery programs.