Regional Anesthesia and Pain Management. Edited by Dell R. Burkey, M.D. Philadelphia, Saunders-Elsevier, 2009. Pages: 414. Price: $69.95.
As we move into the digital age, our information must follow us there. Trying to read textbook-length entries on the small screens of our portable electronic devices can be a daunting task. Fortunately, the publishers of Regional Anesthesia and Pain Management: Anesthesia Pocket Consult for iPod have an entire series of books focused on the rapid reference of information via portable electronic devices. After purchase, this entire book is available for easy download to an iPod device or any other laptop computer (both Mac and personal computer). The physical book is small, and the instructions to download the information to the device of your choice are on the back of the front cover. Having this book readily available on a small electronic device should improve access to information anywhere without looking like an young intern whose white laboratory coat pockets are stuffed full.
The content of the book is divided into three sections: regional neural blockade, acute pain, and chronic pain. The first section on regional neural blockade discusses many common (e.g. , femoral, popliteal fossa) and uncommon blocks (e.g. , obturator, genitofemoral). I found this section to be confusing because there were no upper extremity blocks (interscalene, supraclavicular, infraclavicular, or axillary) and there were two separate headings, 12 pages apart, on the popliteal fossa block, both containing similar information. In addition, the ankle block was divided into separate sections that included techniques to individually block the sural, superficial peroneal, saphenous, deep peroneal, and tibial nerves at the ankle. Although this would be a reasonably different way of presenting an ankle block, these nerves were not found in back-to-back sections. In the middle of the section, describing the nerves of the ankle block, the lateral femoral cutaneous nerve block of the thigh is discussed. Even if accessing this information from an electronic device, finding proper information to perform an ankle block would be difficult. It is not clear why this book is organized in such a manner, but it may be a case of too many contributing authors, too little editing, or both that result in a product that does not flow smoothly.
The sections on acute and chronic pain are more thorough and inclusive. The Chronic Pain section is divided into several different chapters that include pharmacotherapy, interventions, psychologic management, and clinical pain syndromes. Strangely, the psoas compartment block, as described in the text, is “used to provide postoperative analgesia,” but it is found in the Chronic Pain section. The section on neuromodulation/spinal cord stimulation is extremely brief and found under its old, seldom used name electrostimulation.
Overall, I found the chapters brief, but these were still able to cover some of the important aspects of each topic. As intended, this book should be used as a quick reference guide to refresh topics or procedures that one is somewhat familiar. The depth of knowledge provided here does not allow someone to complete a procedure described within when performing it for the first time. For a quick reference guide, I recognize that it is also difficult to cite some of the sources of information in the topics presented. However, some sections left me wondering whether the information was based on evidence or whether it was just passed down over the years. Interestingly, only some sections had suggested readings, whereas others did not.
Some important features that are not included in this version and that I would hope to see in future versions are some small figures of landmarks described for the regional nerve blocks and chronic pain blocks. Something I am always referring to in textbooks, which would be useful to have presented here, is a good opioid-conversion chart. Unfortunately, although opioid conversions are mentioned in the Chronic Pain section, there is no chart included and no conversions suggested.
Some information on the use of ultrasound to perform these blocks could be included, because ultrasound is not mentioned at all in the descriptions of any block in this text. Ultrasound is generating increased interest in both acute and chronic pain settings. The physicians most interested in an iPod-accessible book would most likely be technically savvy and want to know about the uses of ultrasound for these procedures. Also, the electronic version of the book is not compatible with the iPhone or any other smart phone. I would like to see future versions that are compatible with other devices.
Overall, this book may be useful as a quick reference guide, in electronic or paper form, because of its brief descriptions of regional and pain topics. I did appreciate the brevity at which the topics were presented, but the book was far from cohesive or comprehensive.
Virginia Mason Medical Center, Seattle, Washington. david.auyong@vmmc.org
