The Pharmacology of Inhaled Anesthetics. By Edmond I Eger, II, M.D., James B. Eisenkraft, M.D., Richard B. Weiskopf, M.D., Baxter Healthcare Corporation, New Providence, New Jersey, 2003. ISBN: TXV1-035635. Pages: 327 and 2 DVDs. Price: Complimentary.
Authored by a group of distinguished clinician scientists who are internationally recognized for their contributions to the topic, The Pharmacology of Inhaled Anesthetics is an effectively organized, copiously illustrated, well-written review of both the basic and clinical pharmacology of inhalation anesthetics. From a clinical perspective, perhaps the primary aim of the authors was to compare and contrast the newer inhaled anesthetics, sevoflurane and desflurane, with the older, more soluble ones. In the broader context of how this work fits within the collection of existing textbooks on inhaled anesthesia, it can be viewed as an up-to-date review, integrating recent discoveries with well-established knowledge.
The structure of the book conforms to the traditional areas of investigation for inhaled anesthetics. The initial chapters are focused on basic issues including a history of inhaled anesthetics, physiochemistry, the concept of minimum alveolar concentration, mechanisms of drug action, and pharmacokinetics. Several chapters addressing pharmacodynamics are organized by organ system (e.g. , circulatory effects and pulmonary effects). Next are chapters devoted to metabolism and liver-kidney toxicity. The book finishes with very practically oriented chapters discussing inhaled anesthetic delivery systems and clinical applications, offering “how to do it” recipes.
The textbook is accompanied by a number of educational enhancements that clearly increase the overall appeal of the entire package, particularly for residents in training. Each chapter has a list of specific learning objectives. At the end of the book there is a list of study questions intended for students preparing for certification examinations. The answers to these questions can be submitted for scoring and continuing medical education credit. The book is also complete with a DVD-based supplement that complements the text. The DVD is essentially a video seminar focused on the topic; it is organized with the same chapter headings as the book. Filmed in the setting of a small classroom with a group of trainees and author, Edmond I. Eger II, M.D., the DVD seminar is a comprehensive lecture series with standard computer-generated slides. A unique feature of the DVD seminar is the inclusion of “in operating room” video clips created to illustrate the scientific foundation of inhaled anesthesia at the point of clinical care.
The greatest strength of the book is its authoritative authorship. As major contributors to this area of anesthesia clinical pharmacology, these authors have organized their thinking on the topic over decades and are experienced in conveying this knowledge. The book therefore represents an up-to-date review of the entire area. In part because it brings together detailed information that was previously only available in separate monographs focused on the individual agents, and also because it includes the latest discoveries in the field (e.g. , new information about locus and mechanism of action, among many others), the book can be considered a “one-stop shopping” source of information on inhalation anesthesia.
A unique aspect of the book that probably deserves mention is the nontraditional publishing pathway. Inspection of the title page does not mention a publishing house or a Library of Congress catalogue number. The title cannot be found through a search of popular online booksellers that feature current books in print. Because the book and the accompanying DVD recently appeared in the mail boxes of all our residents in training, I have surmised that the book was probably produced as a collaborative educational effort between an industry sponsor and Dr. Eger and colleagues, although it is impossible to be sure by examining the book. A clear statement of support would easily address this confusion and would be appropriate in the spirit of conflict of interest disclosure. In any case, this reviewer believes that the authors have provided a balanced appraisal of the topic.
All in all, I couldn’t be much more enthusiastic about this book, particularly for the resident in training audience. It’s well done. It’s authoritative. And, as best I can tell, it’s free.
