Yao and Artusio's Anaesthesiology; Problem-Orientated Patient Management

This book updates the previous edition, while expanding its remit by approximately one-third embracing new topics and introducing fresh authorship. The book is divided into 11 sections, the first 10 representing an organ system and the last miscellaneous topics, incorporating 62 chapters. A predominant American authorship is preserved but with wider geographical experience than before. Three new chapters on acupuncture, perioperative analgesia, and electroconvulsive therapy embellish this edition.

Despite this diversity, the editors have managed to preserve a thematic approach to each chapter throughout the book. Clinically orientated chapters provide an initial brief case presentation before progressing to expound sequentially four essential aspects of the disorder being considered. These are: (i) the medical disease under review and its differential diagnosis; (ii) preoperative assessment, investigation, evaluation, and preparation of the patient; (iii) intraoperative anaesthetic management; and (iv) postoperative anaesthetic care. Within each chapter, issues are addressed by posing a series of ‘relevant questions’, which are then answered and include some appropriate references. Predominantly, graphical illustrations appear in some chapters. The editors have also incorporated some cross referencing of subject matter to other chapters.

This pedagogic approach will no doubt appeal to many readers but I found the repeated use of abbreviations without adjacent definition and the tendency to quote predominantly American literature an irritation. I would strongly recommend to the editors that the next edition includes a list of abbreviations and their meanings! In my opinion, the ‘problem orientated’ approach fails to deliver in a number of chapters. For example, the chapter on magnetic resonance imaging (MRI) concentrates on a restless 2-yr-old child. The author glosses over paramount checks pertaining to the environment, instead concentrates on the virtues of the laryngeal mask in paediatrics and does not incorporate specific issues about anaesthesia for an adult requiring MRI. There was an apparent error in my copy of the book as both sections 4 and 6 have been classified as covering the endocrine system in the index and the section headings, when it appears section 4 should read the nervous system.

I think the anaesthetist who enjoys theoretical information, presented in the context of a clinical condition, may be drawn to this style of writing. There is no doubt that most authors have attempted to provide comprehensive cover of their subject matter, albeit constrained by the ‘problem-orientated’ framework, highlighting domains of controversy while concentrating heavily on areas where consensus opinion has now been reached, for example, in the definitions of acute lung injury or adult respiratory distress syndrome. Moreover, the indexing system allows the reader to find specific subtopics easily, although I found it necessary to backtrack to original clinical problem sections in order to fully understand context. The pharmacological scope of this book is constrained to US medication, for example, atropine is covered in depth whereas glycopyrollate hardly features and is not indexed.

Overall, I found the book well written and organized. However, although many elements are useful, there are others of less value. For its price, this book represents excellent value for money and while it will doubtless appeal to US anaesthesiologists in training it could find favour with other anaesthetists who like this style of presentation. After careful scrutiny, I remain concerned, however, that although the reader may be enriched in knowledge of the ingredients of an ‘anaesthetic cake’, they will remain oblivious to the wisdom required to bake it!