Bandolier's Little Book of Pain

A. Moore, J. Edwards, J. Barden & H. McQuay ISBN: 0192632477. Oxford University Press, £19.99 ‘Bandolier’ represents the Oxford Pain Relief Unit. It was developed as a method of distributing information about evidence-based healthcare in the form of a bulletin and has proved very successful since its start in 1994. ‘Little Book of Pain’ is an extension of that and claims to provide a snapshot of all the evidence available on analgesic therapies as of mid-2002. Even though the book is little, there is certainly a great amount of information here for all clinicians, even surgeons, who are regularly involved in the provision of effective analgesia to their patients and who do not necessarily have a specific interest in pain management. The book is presented in a similar format to other Oxford Handbooks and is divided into eight broad sections. The first section is dedicated to understanding evidence-based medicine and provides an exceptionally clear explanation of the methodology, outcome measurements and flaws in the pain studies reviewed for the book. The next section covers acute pain. It begins with the very useful ‘league table of analgesics’, followed by reviews of a wide range of analgesic therapies used in the acute setting such as COX II inhibitors, TENS and wound infiltration. The following four sections constitute the main part of the book, covering the wide range of analgesics used in the management of chronic pain and the specific conditions as migraine, cancer and arthritis. A brief, easy to read summary of all the available evidence for each therapy is again presented, and the studies and the systematic review performed for each are discussed. An evidence-based review of complementary therapies is also included as well as a final section on quality and management aspects of delivering a pain service. Although there is a lot of information which would be of benefit to individuals with a special interest in pain, there is sufficient here for any clinician, and certainly any anaesthetist, to make this book a very useful purchase. The clarity with which the methodology of systematic reviews is presented and then discussed throughout the book must be praised. The therapies and evidence considered are up-to-date and any updates on these reviews are apparently available on the Bandolier website (http://www.ebandolier.com). Finally, any book that claims to make you live longer, as promised by Bandoliers evidence-based ‘10 tips for healthy living’– can't be a bad thing.