Oxford Pain Management Library'Back Pain

Oxford Pain Management Library'Back Pain

British Journal of Anaesthesia 111 (1): 129–32 (2013) BOOK REVIEWS Analgesia, Anaesthesia and Pregnancy: A Practical Guide. S. Yentis and S. Malhotra...

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British Journal of Anaesthesia 111 (1): 129–32 (2013)

BOOK REVIEWS Analgesia, Anaesthesia and Pregnancy: A Practical Guide. S. Yentis and S. Malhotra. Published by Cambridge University Press, Cambridge, UK. Pp. 412. Price £45.00. ISBN 9781107601598.

None declared. C. Meer I. J. Wrench* Sheffield, UK *E-mail: [email protected] doi:10.1093/bja/aet188

Oxford Pain Management Library—Back Pain, A. Scouter, R. Cregg, S. Chong (editors). Published by Oxford University Press, Oxford. Pp. 159. ISBN 978-0-190960977-2. This book is of a small easily manageable size. It consists of 15 chapters covering all the relevant areas one would expect including, epidemiology, assessment, and various treatment options including physical, pharmacological, psychological, and interventional treatments. It also includes chapters on the management of failed back surgery, rehabilitation and finishes with a chapter on the overview of back pain, and the future. Each chapter is written by a different individual(s) with interests and expertise in that particular area. Within each chapter they aim to follow best practice and give an evidence base for the treatments. Andrew Baranowski writes in the Foreword, that ‘Back pain is a condition which affects most humans at some time in their life and for a number of patients it can result in significant disability and distress. Patients can present to a wide variety of different practitioners from different backgrounds within primary care and secondary care. Consequently the treatment they receive can be quite variable in terms of both the nature of the treatments and the quality of that treatment’. The back cover of the book itself states that ‘Back pain is one of the most common reasons cited by patients seeking medical help and a leading cause of time off work and longterm disability. Many health care professionals devote a substantial amount of their time attending to patients who suffer from it, and that the initiating event leading to back pain is often compounded by other factors leading to maladapted behaviour and prolongation of pain’. Those of us who spend time managing such problems recognize that one of the problems is the lack of clear pathways of care. Management guidelines, particularly those published by NICE, far from being helpful have instead provoked significant controversy, particular among professionals in pain management. The stated aim of this book is to give clear and concise guidance on the management of back pain. My expectation

& The Author [2013]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: [email protected]

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This well-written obstetric anaesthetic textbook, now in its third edition, rests somewhere between a comprehensive textbook and a quick reference for trainees working on labour ward. It is a little too large to be carried around at work, and trainees in obstetric anaesthesia may prefer a smaller text for this purpose. Its main strength lies in its structure—both overall and within each topic. Read from beginning to end it flows logically, taking us from preconception through to postnatal care and care of the neonate. Its content extends beyond clinical management and includes a final section that covers organizational aspects of the labour ward, including advice on audit, midwifery training and risk management. Each topic is set out in a succinct format that allows the reader to learn quickly about a subject and get straightforward, practical advice. The key points at the end of each chapter are particularly helpful. The information is up to date with frequent references to the most recent triennial maternal mortality report. In many respects, the information provided is more than sufficient to manage the vast majority of cases on a labour ward without further reading. In contrast, some sections, for example, those covering rare diseases, do not provide sufficient information to manage a case comfortably without reference to a larger text. Clearly, this is the authors’ intention and several references are given at the end of each topic to help guide further reading. It would still be a useful resource to access if a more complex patient arrived on a labour ward without warning. One section where more detail would have been welcome concerned anaesthesia for incidental surgery during pregnancy, as this is one of the most common questions that obstetric anaesthetists receive from their nonspecialist colleagues. A further strength of this textbook is that it contains a good deal of information specific to obstetrics, rather than just obstetric anaesthetics. Although the book may have benefited from having an obstetrician as co-author, it certainly succeeds in providing an obstetric perspective that allows the anaesthetist to adjust their management accordingly. In summary, this is a concise, accurate and up-to-date textbook that covers the vast majority of problems an anaesthetist it likely to encounter on the labour ward. It would be an invaluable revision aid for those studying for the Fellowship of the Royal College of Anaesthetists.

Declaration of interest

BJA

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book, which is particularly helpful in deciding the management plan of an individual presenting with a back pain problem. In essence, this is a book, which may usefully sit in a drawer in the consulting room of a GP or back pain therapist.

Declaration of interest None declared. N. D. Edwards Consultant in Pain Management E-mail: [email protected] doi:10.1093/bja/aet189

Manual of Geriatric Anesthesia, S. R. Barnett (editor). Published by Springer, New York. Pp. 441. ISBN 978-1-46143887-8. Some may regard the title of a book dealing with the elderly as a ‘manual’, a little indelicate given its dictionary definition as a ‘user guide’ or ‘instruction booklet’. Is this a reflection of the impersonal world that many elderly people inhabit or does it emphasize the practical aim of the book? If the latter, it is achieved in part, but not universally. Half of all patients .65 will have an operation before they die, and arguably this patient group represents a specialized area of anaesthetic practice with specific needs which, to an extent, have been neglected. With an ageing population, this shift in demographic will significantly challenge healthcare systems throughout the world and as perioperative physicians we have a central role to play in improving the quality of care, not only in the acute setting but also in the areas of chronic pain and in the palliation of terminal disease. This book attempts to draw together many of these relevant subject areas, emphasizing the multidisciplinary nature of care and providing useful background information on ethics and legal aspects and also specific issues of anaesthetic care. There are 25 chapters divided into five sections; general issues, anaesthesia delivery, perioperative care, specialist surgical areas and finally five chapters dealing with common geriatric issues such as psychotropic medication, polypharmacy, cognitive impairment, and management of the hip fracture patient. The first chapter deals with the aging patient characteristic and its implications for healthcare providers and is followed by a chapter on ethical and legal considerations including the assessment of capacity and an interesting discussion on medical futility in the perioperative period, which although broadly applicable, inevitably has a strong North American influence. There then follows general chapters on preoperative assessment and risk which are further complemented, later in the book, by more specific risk analyses within the surgery-specific chapters, most notably the chapters relating to vascular and spinal surgery. There are two excellent chapters on cardiovascular and pulmonary issues in the elderly patient which outline both age-related physiological changes and the anaesthetic management.

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was therefore that it might act as an authoritative but simple guide to managing back pain. Unfortunately it doesn’t. In my opinion, this book is an opportunity missed and my overall response to the book is one of disappointment. The consequence of multi-authorship, particular when individuals come from different specialties and have different and specific interests, is that emphasis on management can be very different between individuals, which is then reflected in their chapters. There is also an inevitable variation in quality. Unfortunately, the editing fails to ensure the consistency in quality, and the continuity and consistency of message, which this book requires. When reading each chapter the impression is given that all patients would or may benefit from each particular treatment being offered and so it is very difficult for a practitioner to ascertain what would be the best treatment option for a patient with a particular problem. As a consequence, while giving information about the variety of different treatment options available, the book does little to prevent the problems, now often seen with back pain management: that of multiple intervention, multiple time spent on ineffective treatments and the prevention of the development of the maladaptive behaviours which can develop. Some of the other chapters are excellent. I particularly liked the chapters on assessment, anatomy and physiology and the physical approaches to the management of back pain. However, some chapters are quite disappointing. For example, the chapter on the overview of back pain could have set the scene for how difficult back pain is to manage, and could have been a very effective initial chapter, the themes of which could then be considered throughout the book. However, it fails to do so and is left as the final chapter in the book. The chapter on the pharmacotherapy of non-specific low back pain merely gives information which can be found in any pharmacological text book. It gives individuals no guidance as to how to prescribe medications for patients with difficult low back pain problems. It is also disappointing that while the book mentions the NICE guidelines on the early management of nonspecific low back pain (again in the final chapter), it specifically states that it is outside the scope of the book. To fail to take the opportunity to critically appraise this controversial document is an opportunity missed. Contrary to the stated aims of the book, in his Foreword, Andrew Baranowski writes that ‘the book is designed to inform and act as a brief reference for practitioners, both medical and in allied specialties working with back pain’. I think that this is a far better representation. It certainly does give information on available treatments and their clinical evidence. If you are looking for information on a particular type of treatment you can find it within the book and you can consider whether that is appropriate for your individual patient. In my opinion, this book is more for individuals who want to look up a particular treatment rather than a book which enables one to decide what treatment options are best for the individual patient. My overall impression of the book is that it does have a place as a concise reference manual. However, it is not a

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