Paediatric Anaesthesia

E. Sumner and D. J. Hatch, eds Edward Arnold, 1999. £65. Since the highly regarded first edition of this book was published in 1989, major developments have taken place in the anaesthetic management of children. This second edition has therefore undergone major revisions to reflect current practice. The aim of the book was to provide a readily accessible and readable source of information on modern paediatric anaesthesia that should help anaesthetists, including trainees, understand the problems that the specialty presents, together with suggested methods of management. This new edition consists of 23 chapters covering a wide range of subjects. Although approximately one-third of the contributors have been chosen from the staff of the Great Ormond Street Children's Hospital in London, the remainder consist of acknowledged experts in their field from around the world. Differences in style and practice can pose a problem in a multi-author book such as this. However, my overall impression is that it is successful, with the contributors expressing themselves clearly, and giving sound, safe advice. A recurring theme throughout the book is the family-orientated way in which paediatric anaesthesia has developed, with both the child and the parents being involved in anaesthetic care. As one might expect in a text on this topic, childhood development, diseases in children and pre-operative preparation are discussed in detail, with difficult and controversial issues being approached in a logical and commonsense way. I found the chapter on unusual paediatric conditions, which highlights congenital syndromes and their associated anaesthetic implications, extremely useful. The pharmacology of anaesthetic drugs in children is covered comprehensively, reflecting changes in practice over the last decade. Areas of specialised paediatric anaesthesia are reviewed, with excellent chapters on cardiac disease and paediatric neurosurgery. However, the section on anaesthesia for neonates and infants is brief, giving an outline of basic principles and referring only to a small number of common surgical conditions. This was the wish of the editors who felt that this specialist area was covered extensively elsewhere. The chapter on airway obstruction deserves special mention. It is clear that the author has a wealth of experience and the photographs of abnormal airways are excellent. New chapters to this edition include pain management, day-stay surgery and sedation outside the operating room, with separate chapters on problems of postoperative recovery and immediate intensive care. The final chapter addresses the issue of the organisation of paediatric anaesthetic services. Although the principles are based on the UK experience, there is much that can be adapted according to local circumstances for use elsewhere. This is a truly excellent book that has built on the foundation of the first edition. Its major strength is the way in which the contributors deal with important issues in paediatric anaesthesia, guiding the reader to clear and sensible conclusions. It is well produced, with an excellent layout and good binding. Although there is some overlap of content between contributors, this allows the reader to learn of different approaches to the same topic. The references that accompany each chapter are comprehensive and up to date. The editors have been successful in producing a book on paediatric anaesthesia that is useful to trainees, consultants with a special interest in paediatric anaesthesia and specialist paediatric anaesthetists alike. It should be available in all anaesthetic Departments in which children are managed.