The Pharmacology of Inhaled Anesthetics (2003)

E. I Eger II, J. B. Eisenkraft, and R. B. Weiskopf.[LINE SEPARATOR] Chicago: HealthCare Press (distributed by Baxter HealthCare Corp.), 2002. 327 pp. Two DVDs accompany text. Professor Eger and coauthors have prepared a treatise on modern inhalation anesthetics that belongs on every bookshelf. The presentation is comprised of three parts. A printed textbook summarizes current knowledge about modern inhaled anesthetics. Two DVDs contain video recordings of lectures. Within these lectures are O.R.-examples of the clinical techniques that apply the theory contained in the lecture. The DVDs each contain a section with multiple-choice questions and answers. Textbook: This book provides a sequel to Eger’s 1974 textbook Anesthetic Uptake and Action (Williams & Wilkins). The older agents (ether, cyclopropane, halothane, enflurane) covered in the 1972 text are almost totally eliminated from this new work. The text is reexpanded to contain the data from the Compendium for Desflurane and comparison studies of sevoflurane. This makes the text the definitive work comparing today’s major volatile liquid anesthetics, isoflurane, desflurane, and sevoflurane. When appropriate, nitrous oxide is also compared. In the course of 275 pages, the important aspects of inhalation anesthetics are explored in 16 chapters. The classical rendition of history, physical properties, MAC (monitored anesthesia care), mechanism of action, kinetics, mutagenic, organ systems (immune, breathing, circulation, neuromuscular, CNS, liver, kidney), metabolism, and vaporization is followed by chapters on clinical applications and techniques. Each chapter begins with an abstract and a set of clearly stated objectives in the form of questions to be answered by the reader. At the end of the book, there are additional specific and in-depth questions related to the content of each chapter. These questions, with their answers, are presented on the two DVDs (see below).. Digital Video Disc (DVD): If the project ended with the textbook, this would be an excellent consolidation of our knowledge of inhaled anesthetics. But this Baxter Distinguished Professor Series product takes the subject of modern inhaled anesthetics and treats it again, in a totally different manner. On the two accompanying DVDs are video lectures where Professor Eger summarizes the content of each chapter in a 20 to 60 minute lecture. In each lecture, Professor Eger interacts with residents and student nurse anesthetists at Wake Forest University and North Carolina Baptist Hospital. The teacher often pauses the lecture as he waits for answers from his students. Within the lectures themselves, Professor Eger uses videos of actual anesthetics administered by the group of learners described above. We see the residents and SNAs trying the techniques that Professor Eger explains in theory. The grouping of in-depth textbook, audiovisual slide presentation interactively with students, combined with real O.R. scenes depicting entire periods of the anesthetic, form a masterpiece of creative multimedia education. The DVDs also contain the multiple-choice questions relating to each chapter in the textbook. They are presented as individual questions. Answers are available with a click of the mouse button. Despite Professor Eger’s stated relationships with Baxter HealthCare, Inc., the text and video present a balanced view of today’s major inhalation vapors, isoflurane, desflurane, and sevoflurane. More information is presented related to desflurane than to sevoflurane or isoflurane. A few features of the overall package (textbook + DVD) are less than ideal. The book’s font size and line spacing provide too much white paper and too little ink. Figures are in blue, but this addition of color doesn’t benefit the reader in any obvious way, and it may be inconvenient for the reader who wants to make copies of graphs. There are typos in the text. The DVD sound level is very low, so it is difficult to hear the lectures well. The menu is only partly interactive; in some situations, it is difficult to get back to the main menu to choose between didactic lectures and features like Q&A or Clinical Answers. The chapters of the DVD appear as titles, all designated Chapter 1. If the DVD Controller is set to display Titles, the chapter number (but not name) is displayed. The section on vaporizers deals mostly with vaporizers for desflurane (Tec 6®D and Aladdin®) and almost ignores the variable bypass vaporizers used for isoflurane and sevoflurane. The chapter on kinetics lacks the insightful model presentations of Eger’s 1972 text. Expanding the kinetic model and the structure-behavior relationship would add to the student’s ability to apply the principles covered in the lectures and text. The lecture figures are fair photographs of projected images. Incorporating the original image figures would make the text on the slides much clearer and possibly allow the learner to download their content. Overall, this textbook plus DVD describing inhalation anesthetics is an exceptional information source for anesthesia care providers and students of this field. It belongs on every bookshelf just as the contained information belongs in every mind.