Publications
APS Bulletin • Volume 10, Number 5, September/October 2000
Resource Reviews
John D. Loeser, MD, Department Editor
Cardiac, Vascular, and Thoracic Anesthesia
Reviewed by L. Brian Ready, MD, FRCPC
J.A. Youngberg, C.L. Lake, M.F. Roizen, & R.S. Wilson, Churchill Livingston, New York, 2000, 974 pages, $195 (hardcover), ISBN 0-443-08920-5
This comprehensive textbook has four editors and more than 65 individual contributors. The book contains 40 chapters and a total of 974 pages. It should be noted that this reviewer is not an expert in the field of anesthesia for cardiothoracic and vascular surgery. Furthermore, many members of the American Pain Society are likely to have limited interest in the content of this volume. Some may therefore question why it is being reviewed for this society. The answer is Chapter 39: ”Postoperative Pain Management.“ I commend the editors of this work for including such a comprehensive chapter dedicated to postoperative pain management. That decision makes a clear statement that contemporary care of complex surgical patients should include careful attention to their comfort and its benefits in the perioperative period. Authors and publishers of surgical textbooks should consider similar chapters.
Steven D. Bell, MD; Joseph L. Seltzer, MD; and Melvin C. Gitlin, MD, FACPM, wrote Chapter 39. It is 19 pages in length and contains 248 references. The areas covered are pain mechanism, pre-emptive analgesia, patient-controlled analgesia, local anesthetics, intercostal and intrapleural nerve blocks, intrathecal opioids, epidural opioids, transdermal therapeutic systems, epidural patient controlled analgesia, transcutaneous electrical nerve stimulation, and acute pain services. The chapter is comprehensive, well organized, and well written. Specific strategies are suggested for using the various analgesic techniques, and a wealth of information is available to the reader.
Although this textbook deals exclusively with anesthesia for cardiothoracic and vascular surgery, Chapter 39 is not as focused. A considerable portion of the content and references deal with issues that are more generic. Given the target readership of this book (anesthesiologists with interest in patients undergoing cardiothoracic and vascular procedures), Chapter 39 would be more useful if it was focused exclusively on the surgical population of interest. It also would be strengthened by a discussion of some of the unique problems associated with providing postoperative analgesia to cardio-thoracic patients (e.g., chest tube pain, postoperative hypotension, and pain management in the sedated and mechanically ventilated patient).
L. Brian Ready is professor of anesthesiology and director of pain service at the University of Washington Medical Center in Seattle.