gms | German Medical Science

Age-dependent characteristics of anatomy, physiology and pharmacology are challenging in the anaesthesia of children. Furthermore some special diseases are even not existing in adults. The small, handily book Kinderanästhesie – nachschlagen, verstehen, entscheiden (Haas, Oswald, Wissenschaftliche Verlagsgesellschaft Stuttgart 2011) offers mainly support to anesthesiologists, who are not daily involved in the anaesthesia of children. The preface accentuate that the book was developed from guidelines and a manual of a certain hospital.

The paperback is well arranged, very clearly developed and offers by the index of content the feasibility to find easily the relevant pages. The list of drugs in the appendix is comprehensive and clear. The book is up to date in the presented therapy recommendations and technical procedures.

The chapter concerning general aspects of child anaesthesia offers a well written overview of the general procedures and contains in text boxes important hints and special pediatric aspects, which are elementary for the support of children under anaesthesia. The procedures are described partly point by point, the size of the required devices is body weight-adapted listed, so the recommendations can be converted directly step by step. This approach is a great advantage of the book and will assure that it is gladly read.

It is mentioned several times that the suggested procedures are standard approaches in Innsbruck. This means “you can do it this way” but it is not postulated that there might be no other approach. Also the important chapter concerning post interventional analgesia is outstanding suitable for the direct use. Clearly tested practical therapy principles are obtained.

A problem of this book lies in the conversion from a local manual to a published paperback, restrictions of permission of drugs are not clearly designated. For example: “Diclofenac: can be given starting from 1 year” (consider recommendations)”. In fact this drug is certified only above 6 resp. 15 years of age in Germany, this information should not be missing in such a text.

In the chapter “special aspects of the child anaesthesia” course of action of the most frequent surgical procedures are mentioned. This chapter shows weaknesses. On the one hand the selection of the surgical procedures appears unclear and on the other hand the anaesthesia techniques, the listed drugs and the infusion regimes are almost the same in the different surgical procedures. This is suitable for a check-list in the local hospital, offers however in this book on several pages redundant information, which could better be presented in one table, as it is placed at the beginning of this chapter. Some neonatal diseases are well described, partly with illustrations, while other important neonatal diseases and principles of therapy are not sufficient mentioned (i.e. the characteristics of the postnatal management of congenital diaphragmatic hernias).

The chapter regarding the equipment for children in the operating theatre is treated negligently. Two of the illustrations are neither clear nor necessary. The presented approaches could have been discussed more briefly. The described transcutaneous CO₂ measurement is well established on neonatal intensive care units, but additionally other techniques are available even in small infants, who undergo surgery. Details regarding respirators for small infants are missing as well as a chapter “difficult airway”. Beside the equipment for a capnometry in case of difficult intubation, also the option of a videolaryngoscopy or fiberoptic bronchoscopy intubation (available techniques and problems in children) should be mentioned.

In conclusion the paperback is well written, with an appropriate price and contains many important, practical hints, so that it will make an eminent support in the anesthesiological care of children.

The author declare that he have no competing interests.