Smith’s Anesthesia for Infants and Children, 7th Edition. By Etsuro K. Motoyama, M.D., Peter J. Davis, M.D. St. Louis, Mosby, 2006. Pages: 1,256. Price: $175.00.

What does one write about a textbook that has been a standard in the field of pediatric anesthesiology for nearly five decades? The seventh edition of Smith’s Anesthesia for Infants and Children , edited by Etsuro K. Motoyama and Peter J. Davis, certainly qualifies as that standard—a standard set by Dr. Robert Smith and passed into the caring, capable hands of Drs. Davis and Motoyama with the fifth edition. The task of writing this review prompted me to take from the shelf my first copy of Dr. Smith’s text, a dog-eared volume marked with endless notes, underlinings, and doodlings that stand as evidence of my devotion not only to their text, but also to the field. It is clear from the enduring quality of Smith  that Drs. Davis and Motoyama share that devotion. It would be sufficient at this point to conclude this review by simply stating that this text has been and remains a standard in the field and all those having an interest in the anesthetic care of children should own at least one copy, preferably two—one for themselves and one to share with a promising student, resident, or fellow who represents the future of our field.

However, the editor has asked that I provide a review of 500–1,000 words that is clear, concise, and entertaining. With his instructions in mind, and a current word count of 260, I will endeavor to supply the reader with three or four hundred additional words about this fine text.

With few exceptions, Drs. Davis and Motoyama have combined the efforts of some of the finest clinicians, researchers, and scholars in the field to assemble a comprehensive yet concise and very readable text. Although the general organization of the text is little changed from previous editions, several sections and chapters have been updated and, in some instances, expanded to reflect advances in the field such as fetal surgery, office-based practice, regional anesthesia, pain management, and psychological aspects of pediatric anesthesia practice. Sadly, in response to the epidemic of obesity among children, a significant portion of one chapter is now devoted to bariatric surgery in pediatric patients.

Several other chapters and topics have been added. Most notable is the addition of a DVD providing an opportunity for the authors to include video and still images that are enormously helpful in demonstrating such procedural skills as fiberoptic intubation, single-lung ventilation, and regional anesthetic techniques. In some of the slide presentations, I found the transition to be painfully slow, although it may have been a problem with my laptop rather that the disc itself. I especially appreciate the addition of still images of some of the myriad syndromes each of us encounter more or less frequently in our daily practices. It would have been a bit more helpful if the photographs were accompanied by a minimum of text to provide the viewer with a brief overview of the syndrome. Likewise, I found the video presentation of normal and abnormal cardiac anatomy to be of limited value. The pathology specimens are difficult to orient oneself to, and, as I frequently find myself suggesting to residents and students, anatomy is for surgeons; we in anesthesiology are most interested in physiology. With that in mind, I wonder whether the next edition might also include video cartoon depictions of various examples of congenital heart disease illustrating alterations in physiology. I find these to be much more useful in helping learners understand approaches to the treatment of children with complex congenital heart disease. Clearly, the DVD represents a good first attempt at the inevitable transition from the bound text to the digital one.

At 700 words, I will close by stating that it is indeed a pleasure to have been given the opportunity to review this text for Anesthesiology. Thanks to the review copy provided by Anesthesiology, I can now retire my old copy of Smith  and spend some quality time with the new improved and updated seventh edition.

Mayo Clinic College of Medicine, Rochester, Minnesota.