Book Reviews

Oxford Handbook of PainManagement

P. Brook, J. Connell & T. Pickering (eds)Oxford University Press, June 2011ISBN 978-0199298143, 366 pp.,Price £32.95

This is the first edition of one of the

latest instalments in the popular and

ever-expanding Oxford Handbooks

catalogue, though perhaps unlike

some of its series counterparts, this

volume is genuinely pocket-sized.

Divided principally into two sections

– acute pain and chronic pain (the

former being significantly shorter) -

the authors address general princi-

ples, management strategies and

specific clinical situations for each.

The book’s value is not limited to a

ready-reference for the pain clinic or

acute pain ward round: succinct

summaries of relevant anatomy,

physiology and pharmacology inter-

spersed with historical perspective

and relevant evidence will appeal to

trainees preparing for clinical duties

and postgraduate examinations, as

well as to more experienced clin-

icians across a range of disciplines.

The acute pain section begins

with an overview of the anatomy,

physiology, pharmacology and assess-

ment of pain. Although a variety of

nerve blocks are described in detailed

bullet points, simple line diagrams

indicating relevant anatomy and nee-

dle insertion points would be a

welcome addition. Postoperative pain

management is reviewed extensively

and consideration is given to mana-

ging acute pain in patients already on

long-term opioids, including substi-

tutes for illicit drugs e.g. methadone.

However, an opioid-to-opioid con-

version table is lacking, and only

passing consideration is afforded to

PCA regimens for opioid-tolerant

patients. There are reviews of analge-

sia for patients in the intensive care

unit, the delivery suite and the

emergency department, as well as

for neonates, children and the elderly.

Since chronic pain was desig-

nated one of the Royal College of

General Practitioners’ four clinical

priorities for 2011–13, the two thirds

of the handbook devoted to this topic

is likely to appeal to a wide reader-

ship. The first chapter addresses

epidemiology, history-taking and ex-

amination of patients presenting

with chronic pain, and is essential

reading for those uninitiated in pain

clinic assessment. Pharmacological

therapies are covered in the next

chapter, and there is a degree of

repetition between the acute and

chronic pain sections; cross-referen-

cing could lessen any confusion this

might cause. Though novel and

atypical agents are discussed, no

mention is made of some of the

newer (tapentadol) or older (nefo-

pam) formulations. Further text-only

descriptions of nerve blocks are

given, and neuromodulatory techni-

ques are explained alongside various

surgical and physical therapies.

Twenty fascinating pages are dedi-

cated to psychological therapies;

merely reading the transcript of a

hypnotic treatment session for

chronic pain left me feeling unchar-

acteristically relaxed and refreshed!

Finally, a well-indexed and expansive

chapter (comprising nearly 25% of the

book) details specific clinical situa-

tions in chronic pain and offers pithy

summaries of complex clinical issues.

It is perhaps inevitable that a

volume designed for dipping into will

include some repetition. Local anaes-

thetic toxicity is mentioned in no less

than three chapters, though briefly in

each. The inclusion of an appendix, or

judicious cross-referencing, could

alert readers to important (and

to non-anaesthetists, little-known)

emergencies such as this. Nonetheless,

in summary, this handbook is a

welcome addition to the armamentar-

ium of any clinician dealing with the

treatment of pain – and is therefore

highly recommended to all.

J. CollinsST3 in Anaesthetics NuffieldDepartment of Anaesthetics JohnRadcliffe Hospital Oxford, UKEmail: collins@doctors.org.uk

doi: 10.1111/j.1365-2044.2011.06986.x

Law and Ethics in Intensive Care

C. Danbury, C. Newdick, A. Lawson &C. Waldmann (Eds)Oxford University Press, June 2010,ISBN 978-0-19-956203-9, 272 pp.,Price £39.95

This interesting and easy to read text

deals with the complex and contro-

Anaesthesia 2012, 66, 341–342

Anaesthesia ª 2012 The Association of Anaesthetists of Great Britain and Ireland 341