Clinical Anesthesia Procedures of the Massachusetts General Hospital. William E. Hurford, Michael T. Bailin, J. Kenneth Davison, Kenneth L. Haspel, and Carl Rosow. Philadelphia, Lippincott-Raven Publishing, 1997. Pages: 816. Price:$34.95.

Clinical Anesthesia Procedures of the Massachusetts General Hospital  is now in its fifth edition. Those familiar with the earlier editions will find little change in the format or style in this new one, which includes 94 additional pages. Much of this derives from the use of a different typeset, but part of it also comes from chapter revisions. The reader might think after thumbing through the first few chapters that few changes have been made, and thus the newer edition does not warrant the $34.95 purchase price. But this would be wrong. It is new and improved. The handbook has been updated to cover newer drugs. Examples include those used to treat hypertension and diabetes and the agents used during operation by anesthetists, such as remifentanyl, milrinone, and ropivacaine. Most of the chapters have been revised extensively. If the reader was pleased with the previous edition, this new edition will not fail to please.

No review, however, would be complete without criticisms, as they might provide the basis for an improved sixth edition. The former typeset allowed fewer pages with no difference in the reading comfort. After all, what good is a handbook that is too large for the hand. There is no listing for latex  in the index, nor will the reader find the word under the chapter that addresses allergies (Chapter 1). There should be twice as many drugs listed in the appendix and in half the space. Also missing are such items as the toxic dose of ropivacaine.

Of the many handbooks on the market, this is the best-selling, and for good reason: It provides a quick reference that is concise and accurate for most issues encountered in clinical anesthesia.