Publications
APS Bulletin • Volume 9, Number 5, September/October 1999
Resource Reviews
John D. Loeser, MD, Department Editor
Essentials of Pain Medicine and Regional Anesthesia
Reviewed by Paul S. Tumber, MD
H.T. Benzon, et al. (Eds.), Churchill Livingstone, Philadelphia, 1999, 483 pages, $69 (softcover), ISBN 0-443-06509-8
The advertisement on the back cover of this textbook expounds that the book is meant for readers looking for one book that “offers an accessible and concise, yet complete, overview of today’s theory and practice of pain medicine and regional anesthesia.” Such a lofty goal cannot realistically be accomplished within 466 pages of text. However, in the preface, the editors point out that the concise format was conceived to serve busy residents, fellows, and anesthesiologists who do not have much time for reading.
The book is organized into eight sections. A simplified review of the basic neurophysiology and neurochemistry pertaining to pain is covered in the first section, as is a short taxonomy chapter that explains a selection of 41 IASP-accepted terms. Section 2 deals with neurological, psychological, disability, and laboratory evaluations (e.g., radiology, neurophysiology). The chapter on radiology is limited to an evaluation of the spine, and the pictures do not depict pathology as clearly as some other texts; however, the chapter on neurophysiological testing is well written. Sections 3 and 4 include chapters that outline treatment options for patients experiencing various types of pain. These include pharmacological, psychological, rehabilitative, and interventional techniques.
Sections 5 through 7 address the broad categories of postoperative pain, chronic pain, and cancer pain, respectively. In the section on chronic pain, eight chapters are devoted to headaches, seven chapters deal with back pain, and four chapters deal with complex regional pain syndrome. The remaining 13 chapters in the chronic pain section convey information on other chronic pain problems commonly seen in practice. None of the chapters focus on abdominal or geriatric pain.
Section 8 deals exclusively with local anesthetics and regional anesthesia (e.g., neuraxial, peripheral nerve, sympathetic blockade) and includes six chapters that discuss various complications that can occur with neuraxial procedures. The anatomy diagrams are not in color, and clinicians looking for detailed information on how to perform various procedures would be better served by reading a dedicated regional anesthesia text.
This first-edition text covers a broad array of pain and regional anesthesia topics, as the title advertises. For the most part, the information is up to date, although there are exceptions, such as the depiction of the 1986 World Health Organization cancer pain algorithm rather than the updated 1990 version. Moreover, the book does include most of the essentials used in clinical practice (an exception is the absence of a discussion of the use of phenylephrine in managing hypotension with epidural anesthesia). It is an easy-to-read book that is suitable for residents, fellows, and other clinicians who are searching for a quick overview of dolorology. Ultimately, the price of the text may dictate whether pain clinicians will want to add it to their collections.
Paul S. Tumber is acting assistant professor in the department of anesthesiology at the University of Washington in Seattle.