The Anesthesiologist's Guide to the OR.

The Anesthesiologist's Guide to the OR. R. P. DUTTON and A. D. GOLDSTEIN. Little Brown and Company, Boston, 1995. Price £25.00. pp. 368. This is an enthusiastically written pocket sized book aimed at the trainee anaesthetist and anaesthetic assistant. It is a guide to a wide range of surgical procedures written from the point of view of the anaesthetist. It is divided into 17 sections, the first of which discusses some general topics including patient positioning, monitoring and intravenous fluids. The subsequent sections are based on the different surgical specialities and the concluding chapter describes anaesthetic management in various peripheral sites. The core of the book is written in a procedure-perpage format with a synopsis of the surgical procedure, patient position, operating time, blood loss, muscle relaxant requirement, monitoring, pain relief and a brief comment about the anaesthetic technique. The most expansive and useful part is the final comments section which describes problems and complications specific to each particular procedure. While the advice about problems encountered during the procedures described is generally straight-forward, the recommendations regarding the anaesthetic technique are sometimes beyond what would be expected of a trainee. An example of this is the administration of a hypobaric spinal anaesthetic while jack-knifed and in the Trendelenburg position for haemorrhoidectomy in a prone patient. In the section titled 'Operating Room Setup' there is no mention of the laryngeal mask airway in the otherwise comprehensive list of airway equipment. The estimated operating times are very generous in some cases. The generic drug names are often followed by trade names which are obviously aimed at readers in the United States. There are several reminders that there is a human being at the other end of the technical procedure and this helps to balance the otherwise jocular style. This is very much a practice rather than principles text. It is an expensive book, and some may dislike the informal style. However, it contains many useful practical points and is an entertaining read. A. Devine Manchester