In the world of anesthesia, very few textbooks resonate with anesthesiologists the way that The Basics of Anesthesia does. This is the 7th edition of this classic, and the timing of this edition coincides with release of an update of the companion study guide, Miller’s Anesthesia Review. The book honors the 33-yr stewardship of Dr. Miller, and ushers in a changing of the guard with Dr. Pardo assuming the role of lead editor. One will quickly notice the growth and far reaching collection of authors that have contributed to this version; there are a total of 87 authors in this edition. There are many familiar names, with the addition of new authors adding a unique and updated perspective.

At first glance, this book looks like previous versions. The organization of the book is what we have come to expect. For an introductory book it is robust: 936 pages. On further inspection, the reader will immediately notice that this edition is much more visually pleasing, with better illustrations and important information more usefully highlighted. Each chapter is organized better than in previous editions, which leads to improved flow overall. Gone is the history chapter. Gone are the numerous appendices and “Please refer to…” comments. Although this is touted as a basics book, there is nothing basic about this book; it is dense with information and, while easy to read, it is not a quick read.

The sections of the book are organized similarly to previous editions. Most of the information in the basic science and pharmacology sections remain the same, but rather than presenting a dry litany of scientific fact, there is a concerted effort to relate the information in a more clinical fashion. The detailed introduction gives the topic a clinical focus, and in some sections a brief historical perspective is provided to make up for the loss of the chapter on anesthesia history. The addition of a physical diagnoses segment in each chapter is welcome, providing more opportunities to tie the scientific facts to clinical practice. The pharmacology section is also enhanced with additional focus on the pharmacologic implications of obesity and advanced age. The updates to common practice, with the exclusion of halothane from clinical practice and the addition of newer drugs like sugammadex, brings the text into alignment with the current state of practice, as well as provides insightful clinical pearls in each section.

The evolution of our specialty and the changing context of anesthesiology practice is reflected in this new edition. There is an expanded and improved section on outpatient sedation, an updated section on hyperalgesia and the opioid crisis in the pain chapter, and a beautifully organized trauma section. Chapter 12 is a welcomed addition, providing an outstanding summary of the current state of the controversial topic of anesthetic neurotoxicity. The addition of the “Human Induced and Natural Disasters” chapter sheds light on important aspects of our current geopolitical realities. In the context of the anesthesiologist as the “perioperative physician,” the text highlights the importance of anesthesiologists as in-hospital physicians whose clinical skills and leadership provide value to the system as a whole. The “Palliative Care” and “Sleep Medicine and Anesthesia” chapters are brief introductions to worlds not very familiar to most; providing succinct, yet complete, overviews of new subspecialties that are evolving and gaining importance in our specialty. One of the most innovative chapters is “New Models of Anesthesia Care: Perioperative Medicine, the Perioperative Surgical Home, and Population Health,” encompassing new initiatives that provide value beyond the operating room, with a focus on the perioperative surgical home. For someone new to the field, it is an excellent introduction to the landscape of health care and the anesthesiologist’s future and role in this rapidly evolving world.

The negatives in this book are few, and most are related to the electronic version of the text. The eBook, while adding convenient access, does not offer anything additive or innovative. In fact, it is essentially a digital copy of the hardcopy book. While there is the ability to highlight text and save “notes,” the search functionality is essentially a word search. On the whole, the regional section was perhaps the most disappointing. Both the paper and digital versions would have benefited from a more through catalogue and description of basic blocks. This could have been an area where the digital version distinguished itself with an enhanced library of digital images or video clips.

As a companion to this text, Drs. Sdrales and Miller offer Miller’s Anesthesia Review, in its 3rd edition. It again has a familiar format to previous versions and is laid out in chapters that match the text. It serves as a very thorough study guide when used in conjunction with the textbook, with open ended questions and detailed explanations that highlight key points. For trainees looking for help in preparation for the American Board of Anesthesiology Part 1A Exam, this book provides an excellent synopsis of the fundamentals; however, this is not the traditional test prep book with multiple choice questions. The use of open ended questions, coupled with the discussions that tie basic science concepts to clinical scenarios, makes this an excellent text to review in preparation for the American Board of Anesthesiology Part 2 Exam as well. It is also available as an eBook, providing convenient access; although it shares The Basics of Anesthesia eBook’s problem of being cumbersome to navigate.

In summary, the 7th edition of The Basics of Anesthesia continues to be an excellent textbook as it offers something to everyone. It remains “must read” for all trainees. Coupled with the study guide, Pardo, Miller, and Sdrales have created an outstanding and up-to-date clinical resource and education tool that provides a strong foundation of knowledge in anesthesiology. For the practicing physician it offers a good refresher and quick reference. This book serves to honor previous versions and shows that the future of this classic is in good hands.