Now in its fourth edition, Fundamentals of Anaesthesia is, and will remain, a classic of British anesthetic literature. First appearing in 1999, following the development of the syllabus of the feared Fellowship of the Royal College of Anaesthetists exam, the book aimed to cover the majority of the syllabus. Due to the ever-evolving nature of medical practice, not least with the increasing role of technology in anesthetic practice, whether in the form of ultrasonography or hemodynamic monitoring, this textbook has similarly evolved while remaining focused on the basic principles of anesthesia.

This edition, like its predecessors, is divided into four sections: clinical anesthesia, physiology, pharmacology, and physics and clinical measurement. These sections are subdivided into a number of chapters offering a comprehensive review of all aspects of these sections. The physiology chapter in particular provides a review of aspects of physiology relevant to clinical practice, and even the trained physician would benefit from occasionally reviewing these aspects. A notable improvement in this edition is seen in the clarity of the illustrations provided with more color without an overabundance of detail as well as the highlighting of particularly important facts in yellow and green boxes, emphasizing examples, calculations, or techniques.

Revisions to this edition include an update of clinical guidelines in areas such as preoperative assessment and the ever-changing resuscitation guidelines. International readers should note that these guidelines orient themselves primarily on the Association of Anaesthetists of Great Britain and Ireland (London, United Kingdom) and the U.K. Resuscitation Council (London, United Kingdom). One new addition is the inclusion of information on ultrasound-guided regional anesthesia. Although obviously relevant, a book of this nature cannot do the subject justice and those of us used to carrying out regional anesthesia will learn little from this addition. It is somewhat surprising to see the detail presented regarding the landmark techniques for blocks such as axillary and supraclavicular blocks. It is unlikely that anesthetic trainees will learn such techniques, given the almost ubiquitous presence of ultrasound machines these days.

Unlike many textbooks in recent years, this book does not come as an interactive electronic textbook with additional content. This may reflect its primary use in the United Kingdom as a revision guide where an electronic version would prevent the annotating, highlighting, and general dishevelment, which inevitably occurs during its extensive use. The Kindle version is generously priced, being half the price of the printed copy, a trend which other publishers should take note of.

In conclusion, these experienced editors, who have all been involved since the first edition, Colin Pinnock having recently died after a significant career in anesthetic education, have produced a fresh, modern version of a well-known, well-loved textbook that will find its place on the shelf of those in training or those looking to keep their basics up to date.