How to Survive in Anaesthesia: A Guide for Trainees, 3rd Edition. By Neville Robinson, F.R.C.A., and George Hall, M.B., B.S., Ph.D., F.I.Biol., F.R.C.A. Oxford, United Kingdom, Blackwell Publishing, 2007. Pages: 200. Price: $35.00.

All of us can undoubtedly remember the terror of being in the operating room for the first time. Most could barely recognize the anesthesia machine, let alone know how to properly perform safety checks. Although new trainees have undergone extensive medical training before working in the operating room, very little of that knowledge helps in understanding what it takes to adequately monitor a patient or induce general anesthesia. How to Survive in Anesthesia  can do for new anesthesia trainees what Surgical Recall  has done for medical students on their surgical clerkship.1In short, it's a great resource to help students or residents quickly acquire a core knowledge of the specialty.

Robinson and Hall state in the preface that this book emphasizes the basic principles of conducting a safe anesthetic. All who have worked with learners recognize that a respect for safety is the first thing that must be taught. Although the book is brief, it is surprisingly detailed in many of the topics regarding safety. For example, the first chapter fittingly addresses evaluating the airway. Although first-time readers may not know how to best manage  a difficult airway after reading this chapter, they will be much better at recognizing  one. In addition, the chapter on anaphylactic reactions has a thorough description on how to manage this life-threatening condition. There are also details regarding common surgical conditions that can make a relatively straightforward anesthetic more difficult. For example, in the section addressing laparoscopic surgery, the authors concisely review problems from gas insufflation, complications from trochar insertion, patient positioning, and conversion to an open procedure.

How to Survive in Anesthesia  is written in British English. For those training outside of the United Kingdom, this may cause some confusion. In most cases, it is a minor distraction; however, some differences may be less benign. For example, oxygen e-cylinders are color coded differently in the United Kingdom than the United States. This may lead to uncertainty during the anesthesia machine checkout. Another difference comes in the name of a few drugs, e.g. , succinylcholine is called suxamethonium.

The authors chose not to include drug doses, so the medical student or new resident will need an additional drug reference to learn the standard anesthetic medications and their doses. Another caution about the book is that some of the information is not up-to-date. Specifically, the most recent guidelines for advanced cardiac life support are not included in the chapter on cardiac arrest. Furthermore, the advice to not wear gloves when applying adhesive tape during intravenous cannulation is clearly contrary to the concept of Universal Precautions.

As would be expected from an introductory text, the book does not thoroughly cover the subspecialties of anesthesiology, but what it lacks in detail it makes up for in style. The text uses review boxes highlighted with a gray background to help make key concepts and important facts stand out and be readily accessible. These elements, in combination with the simple and humorous writing style used by Robinson and Hall, make How to Survive in Anesthesia  a quick and enjoyable read. The book is compact and designed to fit in the pocket of most white coats, so trainees can review material between cases or during unexpected delays.

In summary, How to Survive in Anesthesia  is an excellent resource for new trainees (medical students or new residents) who want a succinct synopsis of the basic concepts in anesthesia. The authors place a premium on safety. The book is designed for fast reading, with an emphasis on recalling key concepts. At a cost of approximately $35.00, it is easily affordable for trainees on a tight budget.

Mayo Clinic College of Medicine, Rochester, Minnesota.

Blackboune LH: Surgical Recall. Philadelphia, Lippincott Williams & Wilkins, 2002
Lippincott Williams & Wilkins