Cambridge Handbook of Anesthesiology

This book is edited by two highly accomplished anesthesiologists and the contributors are a long list of skilled anesthesia clinicians. The introduction, written by Dr. Douglas Bacon, is a delightful reminder of the complex history behind our practice of anesthesiology. Dr. Bacon's wonderfully woven historical tale is evidence of his incredibly important work at the Wood Library-Museum of Anesthesiology.The Cambridge Handbook of Anesthesiology highlights key ideas from our major anesthesiology texts. It is a compact book that is packed with high-yield anesthesia topics that would be appropriate for a wide variety of anesthesia learners. The utility of the book is in the succinct but comprehensive presentation of anesthetic topics that are not bogged down in cumbersome explanations. Individual chapters explore important topics that are logically arranged, and the length is suitable for quick referencing. Further, the use of strategically placed tables to present the most important points is smart and useful to learners, especially when coupled with review quizzes at the end of chapters.Many chapters do a great job presenting the most relevant topics and known issues that have not changed much over the years. For instance, chapter 7 is an excellent review of local anesthetic pharmacology and includes all the historical key points, including local anesthesia systemic toxicity and intralipid treatment. Likewise, chapter 10 is an excellent review of complications encountered in the postanesthesia care unit and provides a nice high-yield summary for any provider. Further, chapter 20 provides a great and comprehensive overview that hits all the relevant topics regarding endocrine disease, while chapter 21 and chapter 22 provide an excellent overview of anesthesia for neuromuscular disease and ocular, ear, and throat disease.There are chapters in which I would like to see more expansion of topics and possibly more illustrations. For example, chapter 12, on fluids and electrolytes, gives an excellent explanation of various electrolyte disorders. However, a more thorough discussion of fluid balance and goal-directed fluid therapy is lacking. Chapter 24, "Obstetric and Gynecologic Anesthesia," provides the high-yield points well with Table 24.1 being a great succinct list of physiologic changes of pregnancy. However, a stepwise approach to postpartum hemorrhage, a high-stakes topic in obstetric anesthesia, would be useful. There are several chapters that discuss regional anesthesia and, although there are great explanations, including color pictures here would increase the impact to the learner. Chapter 25, "Pediatric Anesthesia," lacks the specifics of pediatric disease. Although there is a nice discussion of pharmacokinetics, pharmacodynamics, and unique pediatric physiology, it lacks specific perioperative considerations and pediatric diseases. Overall, this chapter lacks specificity of topics that are important to learners.The first chapter discusses the anesthesia preoperative evaluation and provides evidence-based information for even the most contemporary issues, such as frailty, malnutrition, and cognitive dysfunction. However, it also provides evidence-based information for optimization of cardiopulmonary disease, a major consideration of preoperative medicine. One challenging subject in preoperative evaluation is the perioperative management of anticoagulation that lacks discussion in the first chapter. However, the final chapter of the book, chapter 35, "Coagulation," is devoted to this, but some easy-to-use tables that list drugs, class, and half-life as well as the American Society of Regional Anesthesia recommendations would strengthen the discussion of this topic. Given the attention that brain health has received in recent years in our profession, I would have liked to see chapter 32, "Perioperative Cognitive Disorders," be an earlier chapter in the book and further be more closely tied to the subject of preoperative evaluation and risk reduction. Having said that, chapter 32 is well written and gives a comprehensive review of the relevant issues surrounding brain health and the impact we as anesthesiologists can have on a patient's brain health perioperatively.In summary, this book provides many of the foundations of anesthesia practice that have been taught for many years. However, it also provides an evidence-based approach to many common challenges for which we now have good data. Further, it provides short chapters on the major topics of anesthesia and uses tables and quizzes throughout to emphasize salient ideas. Including more illustrations, especially for regional anesthesia, might be considered to increase effect. In addition, the pediatric anesthesia chapter is a great introduction to pediatric anesthesia but does not discuss some of the unique challenges in pediatrics based on various comorbidities. Overall, this book provides a solid refresher for many anesthesia topics and is small enough to carry anywhere!