Neural Blockade in Clinical Anesthesia and Management of Pain. 3rd ed

Section Editor: Norig Ellison. Neural Blockade in Clinical Anesthesia and Management of Pain. 3rd ed., Michael J. Cousins and Phillip A. Bridenbaugh, eds. Philadelphia: Lippincott-Raven, 1998, ISBN 0-397-51159-0, 992 pp, $169.00. This is the anticipated revision of a text that has long been a standard in the practice of pain management. This edition has been updated to include many of the changes and advances that have occurred in the 10 yr since the last edition was published. As with the previous edition, this book covers all aspects of neural blockade, including basic neuroanatomy and neurophysiology, pharmacology of local anesthetics, benefits and complications of neural blockade, and techniques of numerous blocks. Although many of the blocks often used in pain management are discussed, as would be expected, the pathology, diagnoses, and treatment of pain problems are not detailed in this book. The properties of local anesthetics, including newer drugs such as ropivacaine, are reviewed in detail. Neuroanatomy is also discussed; however, this section has not been updated from the previous edition. Unfortunately, in this section, preganglionic sympathetic fibers are still classified as B fibers, a class of fibers now known not to exist, instead of C fibers. The stress response to surgical stimuli is discussed in an outstanding chapter. The physiology of the stress response is reviewed. Included in this chapter are the multiple systems involved and the complications that may result. Different methods and their efficacy in blocking the stress response are discussed. The use of blocks in pain practice is comprehensively covered. Multiple blocks essential to the practice of pain management, from the face and head to the neuraxis to the lower extremity, are detailed. However, blocks are not presented in a "how-to" manner. Instead, not only are techniques for the various blocks covered, but, just as importantly, the equipment, preparation, and discussion and understanding of possible complications necessary for the safe conduction of neural blockade are also included. Multiple radiographs, color photographs, and drawings are used to illustrate the blocks, which greatly enhances the text. Diagnostic and neuroablative procedures, including chemical, radiofrequency, and cryoablative techniques and implantable therapies, are discussed. This book provides a balanced view of neuroablative techniques. Unlike some books, this text indicates that the long-term sequelae of some neuroablative techniques are not known and may potentially prove to be of little or no benefit. Neural blockade in pediatric patients is also included. The pediatrics chapters have been updated to include a larger section on the use of neuraxial opioids, assessment of pain in children, and neonatal nociceptive mechanisms. An excellent synopsis of the current knowledge of neurosensory mechanisms and neurochemistry of nociception is included. Features of several common pain diagnoses are also summarized, although they are more comprehensively discussed in other pain textbooks. This book, one of the most comprehensive on neural blockade for both chronic pain and acute pain, remains an excellent complement to textbooks on pain theory and pain management. This book should be in the library of anyone practicing pain management. Maywin Liu, MD Department of Anesthesia; University of Pennsylvania; Philadelphia, PA 19104-4283