Sedation Analgesia for Diagnostic and Therapeutic Procedures

Description

• Author: S. Malviya, N. Naughton and K. K. Tremper
• Publisher: Humana Press, New Jersey
• Pages: 310

Sedation Analgesia for Diagnostic and Therapeutic Procedures

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S. Malviya, N. Naughton and K. K. Tremper (editors).
Published by Humana Press, New Jersey.
Pp. 310; indexed; illustrated. ISBN 0-89603-863-7.

Given the recent attempts by the Academy of Medicine to promote safer sedation, I had hoped that Sedation and Analgesia for Diagnostic and Therapeutic Procedures would contain helpful advice and guidance. I was greatly disappointed. With 18 of the 19 contributors coming from the USA, the book is clearly written for an American audience. All of the specific guidelines, rules and regulations are American, with no discussion of policies and practices in any other countries. While the basic principles may be similar, confusion is likely, as what is ‘mandatory’ in one place may only be ‘recommended’ elsewhere and vice versa. Predictably, American spellings are used, but alternative drug names used in Europe are not even acknowledged, which could be confusing and possibly dangerous.

Much of the book seems to lack focus. From the title, I would not expect sedation in the intensive care unit or general anaesthesia to be covered, except in passing. Unfortunately, several chapters devote many pages to these issues. That others do not implies a lack of editorial guidance and control. Material is often inappropriate for the target audience, claimed to range from investigators and physicians to nurses and administrators. For example, Chapter 5 Table 1 lists Malampatti class III as a risk factor that should trigger discussion with an anaesthetist. While I do not dispute this sage advice, the authors really should have defined the Malampatti classification, which I doubt would be known to anyone other than an anaesthetist. Practical tables and figures have not been used as consistently and effectively as the editors had hoped. The index also seems rather basic. Neither intranasal midazolam nor the aforementioned Malampatti classification are listed, despite several mentions in the text. The interaction of midazolam with opioids is indexed to only one of its multiple citations.

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