Abstract
This book is a comprehensive and user-friendly anesthesia reference for the small animal practitioner. It is a collaboration by 30 international authors, including veterinary anesthesiologists based in Canada, the USA, the United Kingdom, Ireland, Austria, New Zealand, Switzerland, Germany, and the West Indies. As a result, it reflects the diversity of anesthetic drugs and techniques found in different parts of the globe. This makes for interesting reading, although at times the material reflects a particular author's background e for example there is a comprehensive section on government regulations in the UK that govern the use of narcotics, but almost nothing on US regulations.
In general, however, the material is presented very well. There are many excellent quality, full color illustrations. The diagrams, particularly those for local anesthetic blocks, are clear and easy to follow. A great deal of information is summarized in table form, making it suitable for quick reference. The written text itself is generally readable and surprisingly uniform, given the number of authors involved.
Topics are presented in a manner fairly well suited to busy practitioners and include standard material such as patient monitoring, breathing systems and anesthetic equipment, and premedication, inhalant and intravenous anesthetics. Twelve chapters are devoted to specialized areas of anesthesia such as ophthalmic surgery, thoracic surgery, and pediatric anesthesia. Pain management is well reviewed, being the focus of 4 of the 29 chapters. The book also offers an overview of many ancillary subjects, including fluid therapy, postoperative care, non-traditional methods of pain control (for example, transcutaneous electrical nerve stimulation) and legal and ethical aspects of anesthesia. For each topic, the authors present both basic and advanced concepts, with some material going beyond the level of interest of the average veterinary practitioner (not many practitioners, for example, would need to consult the diagram of the Arndt endobronchial blocker system).
One nice feature of the book is the comprehensive and up-to-date information it contains on anesthetic equipment and patient monitors. There is a whole chapter on automatic ventilators! The practitioner who is considering purchase of equipment such as a ventilator or a capnograph will benefit from the clear discussion and illustrations of the various models currently available, as well as lucid instructions on their proper use.
For many readers, this book is likely to be particularly useful for the very current information it contains on anesthetic drugs, including indications, cautions, dosages, and combinations with other drugs. The book presents this material admirably, with an abundance of useful tables that allow quick access to information, along with detailed discussions of hot topics such as the use of atropine with medetomidine, or the relative merits of various induction and premedication drug combinations. Tables I found more useful included: induction and maintenance doses for drugs used as constant rate infusions in conjunction with inhalation anesthesia; IV drugs used for long-term sedation of seizuring patients; and a wonderful chart of 11 drugs commonly used for preanesthetic sedation, including time to peak effect, duration of action, reversibility, and analgesic potency.
There are a few disappointments. I was unable to find a table on constant rate infusions for analgesic agents used for postoperative pain control. I was disappointed that very little information was included on monitoring waste anesthetic gas levels through the use of badges. The section on scavengers is also brief, and not very helpful for persons looking for information on the installation of a scavenger system. These are minor points, however, and overall the book can certainly be described as a comprehensive (even encyclopedic) reference.
Does the usefulness of this book to a feline practitioner justify the cost? This of course depends on how often it is consulted, and for what purpose. The primary focus is not on cats, although the various aspects of feline anesthesia are carefully outlined and there is frequent mention of the differences between canine and feline anesthesia. Much of the information goes beyond the everyday routine of a veterinary practice, but this is not necessarily a bad thing. I suspect that most veterinarians, (like myself) don't read many veterinary books cover-to-cover these days e usually I consult a book to obtain information on a specific topic of interest. By doing this, I think we miss out on something important. For most of us, our knowledge of anesthesia is based on what we learned in veterinary school, supplemented in more recent years by snippets of information derived from conference speakers, journal articles, and drug salespersons.
In reading the book I was struck by the diverse advances in our basic understanding of anesthesia that have taken place since I was in school. When I was a student, we learned that there were three types of opioid receptors e this book informed me that four types are now recognized. That's not vitally important to veterinary practice, but the book is full of interesting tidbits like this and some of them are of practical importance. For example, I was interested to read that it is not recommended that lidocaine and bupivacaine be mixed together for administration to a patient, as the combination produces little change in onset time and a significant decrease in duration of action when compared with administration of bupivacaine alone. Who knew?