Controversies in Obstetric Anesthesia and Analgesia


  • J. Lermitte,

  • M. Morosan

Controversies in Obstetric Anesthesia and Analgesia I. McConachie ( ed .) Cambridge University Press , March 2012, ISBN 978-0-521-17183-0 , 264 pp., Price £42.75 (print); £28.91 (Kindle)

This book deals with exactly what it says on the cover: controversial topics in obstetric anaesthesia. The list of contributors includes obstetric anaesthetists from both sides of the Atlantic. This collaboration is useful as it refers to UK guidelines and national audits (e.g. National Institute for Health and Clinical Excellence, Confidential Enquiries into Maternal Deaths, National Audit Project (NAP) 3) and includes the latest studies published abroad.

It contains 21 chapters, each following a predetermined structure, including general, maternal, fetal and anaesthetic considerations, ending with useful summary points. In addition, each section contains a comprehensive reading and reference list.

You will find the chapters on ‘Cardiac disease in pregnancy’, ‘Hypotension following spinal anaesthesia’ and ‘Epidurals and outcome’ very useful, whether you are a trainee revising for your final exams or an anaesthetist with a special interest in obstetric anaesthesia. The diagrams on congenital cardiac disease, showing blood flows and chambers’ pressures, make a challenging topic easy to understand. However, we did not understand why these diagrams are presented twice in the book.

Ephedrine versus phenylephrine, and complication rates of epidurals versus combined spinal-epidurals, are well summarised in tables, while the chapter ‘Controversies surrounding airway management and caesarean delivery’ discusses the use of videolaryngoscopy and laryngeal mask airways, the choice of neuromuscular agents and cricoid pressure. The chapter ‘Ultrasound guidance for epidural anaesthesia’ contains all the things one would expect, although the images included could have been of better clarity.

In conclusion, we found the book a must for any anaesthetist on the obstetric rota. It provides good background information for helping trainees to weigh the pros and cons of every technique and also to communicate better within the maternity team.