Saturday, July 20, 2013

Anesthesiologist's Manual of Surgical Procedures 4e, Jaffe

Anesthesiologist's Manual of Surgical Procedures 4th Edition by Richard A. Jaffe offers comprehensive guide to the anesthetic and perioperative management of patients during all procedures performed by general and subspecialist surgeons.

The book explains each procedure from both the surgeon's and the anesthesiologist's perspective, presents details on anesthetic technique, and guides the anesthesiologist and surgeon through the decisions that must be made before, during, and after surgery. Emphasis is on factors that impact the anesthesiologist, including patient positioning, duration of surgery, and complications.

The Fourth Edition covers almost 40 new surgical procedures, with an increased focus on laparoscopic and endovascular procedures. A companion Website will offer the fully searchable text and an image bank. The editors do an excellent job of bringing the perspectives of both anesthesia and surgery to each procedure, and include more than 700 procedures. A significant addition to this edition is chapters devoted to office based anesthesia and emergency procedures.

The surgical considerations section concludes with a summary of procedures. This section provides a fascinating insight into the surgical perspective on perioperative care. Aside from information on positioning, special instrumentation required, the incision, and predicted surgical time, a valuable information mine is present in the form of the ‘unique considerations’ section.

These sections often reveal the operating conditions that the surgeon is expecting to be provided by the anaesthetist. While mainly being extremely useful, especially in the cases of surgical procedures unfamiliar to the reader, sometimes surgical requirements appear more than a little prescriptive, perhaps due to the slightly different dynamic in the relationship between the American surgeon and the anaesthetist. Nowhere is this more apparent than the postoperative care sections.

Anaesthetic considerations are always divided into the familiar headings of preoperative, intraoperative, and postoperative. These sections are clearly and very competently written and provide concise information on anaesthetic technique, pathophysiology relevant to individual conditions, preoperative investigations, and postoperative complications.

The book concludes with a section entitled ‘Emergency Procedures for the Anesthesiologist’, which outlines techniques for performing procedures such as pericardiocentesis and arterial cutdown. This chapter appears a little ectopic, and is well covered in other, more conventional textbooks of anaesthesia. Similarly, the appendices covering topics as diverse as preoperative laboratory testing, perioperative beta-blockade, and ‘standard adult anesthetic protocols’, while well and clearly written, are quite heavily influenced by local practice and again are better covered elsewhere.

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