Anesthesiology (1997)

Anesthesiology: A Comprehensive Study Guide, Jeffrey Katz, ed. New York: McGraw-Hill, 1996, ISBN 0-07-033986-4, 622 pp, $90.00. Many authors have attempted to take on the ambitious challenge of writing a review book that is both concise and practical in preparing for board examinations and easy to use as a periodic review, while still covering the broad fund of knowledge necessary to be a competent anesthesiologist. Anesthesiology: A Comprehensive Study Guide, edited by Jeffrey Katz, was produced in an attempt to accomplish this daunting task by narrowing the book's focus to cover the material needed for preparation for the written examination of the American Board of Anesthesiology. Several aspects of this study guide are good and accomplish the goal of the book well. The format lends itself to quick reading, which should be a goal of every review book. The layout is ideally suited for preparing for the written boards by providing pertinent facts in outline form, allowing the reader to quickly review a topic and gather the key points. It provides an excellent starting point to direct readers to areas in which they may need more in-depth review. Helpful clinical points and practical tips can be found scattered throughout the various sections. The text is divided into four broad sections: "Review by Systems," "Pharmacologic Principles," "Principles of Technology and Measurement," and "Special Clinical Situations." These sections are further divided into numerous specific topics. "Review of Systems" is fairly well organized, with respiratory, cardiac, central nervous, urologic, hepatic, endocrine, and autonomic systems subdivided into categories including anatomy, physiology, pharmacology, and disease states. Specifically, some subsections, such as "Valvular Heart Disease," deserve merit. It is written well and provides in-depth coverage of the etiology of the various valvular abnormalities, signs and symptoms, and indications for surgery, as well as anesthetic considerations and management. The description of anesthetic equipment, including many easy to read diagrams, is also very thorough. The section covering principles of technology and measurement is much too lengthy and detailed for the purpose of this text. A total of 35 pages encompasses detailed discussions of topics such as statistical analysis programs, inference on population means, differential equations, and complex variable and transform analysis. Another 16 pages cover the physics of electricity, computer networks, wireless telecommunications, batteries, and medical imaging systems. Overly verbose and detailed coverage, entailing 11 pages, is dedicated to altitude physiology and hyperbaric and diving physiology. Unfortunately, other topics vastly more applicable to preparation for the written boards should have been better emphasized. For example, chronic obstructive pulmonary disease is covered in less than one page. This study guide is lacking desirable details in other areas, as well. The text is devoid of references and suggested readings. As a result, the authors' stated opinions, which are not universally accepted, lack supporting data. For example, one author recommends that the reader avoid regional anesthesia in patients with hypertrophic cardiomyopathy. Although there are several concerns regarding regional anesthesia in these patients, none of which were mentioned, this condition is not a contraindication to regional anesthesia. A discussion or list of concerns regarding this technique in this patient population would have provided a more comprehensive understanding of this disease state. The recommendation to give diabetic patients half their morning dose of insulin on the day of surgery is also not universally practiced and represents only one of many options. A review book is a compilation of information from many sources, and the author should have provided appropriate references for this information. This reference list could also serve as an aid to the reader seeking direction for more in-depth information. Anesthesiology: A Comprehensive Study Guide, has attempted to provide the framework for preparation for the written examination given by the American Board of Anesthesiology. The outline format is very well suited for this task and makes this book somewhat unique since few review books use such an easy to read format. As a guide to prepare residents for the written boards or as a quick reference for medical students and practicing anesthesiologists, the book generally serves this purpose well. Unfortunately, the lack of references or suggested readings, along with the disparate coverage given to many topics, detracts from this otherwise successful effort at writing a comprehensive study guide. Steven L. Herling, DO Department of Anesthesia; Brigham and Women's Hospital; Boston, MA 02115