Textbook of Neuroanaesthesia and Critical Care

Textbook of Neuroanaesthesia and Critical Care B. F. Matta, D. K. Menon, and J. M. Turner. London: Greenwhich Medical Media Ltd, 2000. ISBN: 1-900-151-731. 448 pp. 119. 00 Dimitry Baranov, MD, Department of Anesthesia, University of Pennsylvania, Philadelphia, PA Until recently, practitioners or residents in anesthesia taking an interest in neuroanesthesia were confronted with a limited choice of texts dedicated to this particular field of anesthesia. However, in the last decade a number of neuroanesthesia texts were published, covering most topics related to this subspecialty. This abundance of existing texts on the subject makes it quite difficult to justify a publication of just another textbook of neuroanesthesia unless it provides some additional information pertaining to this particular field or takes a novel approach to discussing established topics. That is what this newest textbook is attempting to do. This is a concise, up-to-date text covering most issues related to modern neuroanesthesia and neurointensive care. The textbook is divided into five sections containing 29 chapters altogether. Although the first five chapters conventionally deal with neuroanatomy, neurophysiology, and neuropharmacology, the rest of the book’s focus is rather unconventional. One quarter of the book is entirely devoted to issues of central nervous system monitoring in neurosurgical and critical care patients. These include an in-depth description of the most recent modes of brain monitoring, some still in development, such as multimodal monitoring, brain chemistry monitoring, and cerebral oximetry. Possible future modalities of brain monitoring are discussed, providing the reader with a useful perspective of ongoing research in this area. It is unlikely that continuous studies of cerebral blood flow, the main focus of neuroanesthesia research until now, will lead to any further significant improvements in patients’ morbidity. Such a progress would require a development of newer and different monitoring modalities of brain well being. This point of view justifies heavy emphasis on the subject of brain monitoring chosen by the authors. The section on postoperative and intensive care provides an extensive overview of this topic, including practical recommendations on different aspects of critical care of patients in neurointensive care units. This probably reflects the fact that neuroanesthesiologists in the UK are directly involved in the decision-making process regarding these patients. This section also contains an interesting chapter on issues of brain death and organ donation that provides useful information on differences existing on both sides of the Atlantic in regard to this subject. The section on anesthesia techniques for neuroimaging procedures contains an excellent overview of various issues related to administering anesthesia for magnetic resonance imaging procedures. After reading this chapter, most practitioners should be comfortable in providing anesthesia for these procedures. The section on anesthetic management for various neurosurgical procedures is very concise and written in a manual-like style. However it covers most practical aspects of neuroanesthesia practice. The practitioner in need of more in-depth knowledge on particular procedures would be well advised to consult more comprehensive texts. Despite the fact that all chapters were written by authors from the same institution, there is very little bias, even in those chapters where one can expect it most–discussions on anesthetic techniques for neurosurgical procedures. Also, there is little redundancy in the text beyond a reasonable amount of repetition among chapters, without which the readers would often be required to refer to other parts of the book. Throughout the text, there are a number of errors in referencing and mismatches between the text and illustrations, although this doesn’t interfere with overall readability of the book. Boxes and tables summarizing the information provided in the text are frequently used, making it easier to systemize the chapters’ content. In summary, this book is a reasonably useful addition to the fast-expanding body of neuroanesthesia literature especially to readers with particular interest in the newest developments in brain-monitoring techniques and those directly involved with the intensive care of neurosurgical patients.