Anaesthesia for the High Risk Patient

Ian McConachie Publisher: Greenwich Medical Media Ltd., 2002. Price: £22.50 With an increasingly aged population, we are likely to be faced with larger numbers of patients presenting for major surgery with co-existingmorbidity. This book brings together a number of different aspects from anaesthesia, related to the high-risk patient and therefore has a very practical outlook. The book covers a wide range of subject matter including the definition and assessment of risk, NCEPOD, regional and general anaesthesia, peri-operative analgesia and postoperative care. The authors emphasise the cardiorespiratory risk and potential impact of anaesthesia on other organ systems. Obviously in a book with such a broad base, a certain amount of background knowledge is assumed, even so aspects of basic care are not overlooked. The book presents reasoned arguments supported by relevant literature references, to support adopting particular approaches in clinical institutions. There is a common sense approach to the care of patients especially as the more contentious areas of peri-operative care are discussed. With any collection of chapters from different authors there is some slight variation in style between chapters. However, each section is laid out in a logical manner and although theamount of prose varies, the key facts are presented in the form of bulleted lists, much favoured by those studying for exams. It was encouraging and interesting to read a chapter presented from a cardiologist's perspective. There is of course no substitute for experience; however, this book forms a useful point of reference for trainees. Its ordered, no nonsense style provides a clear overview supported by references and further reading to consolidate knowledge. The bulleted style makes for an ordered aide-memoir when studying for exams. Finally, the more experienced anaesthetist, although practising much of what is included in this book may well find that it helps crystallise their thoughts when presented with particular clinical situations.