Body Temperature Control in Anaesthesia, Surgery and Intensive Care

THIS book documents the evolution of the practice of extradural analgesia in obstetrics during the last decade. Its pre-runner, published in 1972, did much to add momentum to the growing demand for this form of pain relief for the parturient. Contributors include Bromage and Abouleish from the USA, Jousten, Fuster, Van Steinberge from Western Europe and Moir, Doughty and Crawford from the United Kingdom. The differing viewpoints of acknowledged experts regarding details of technique and clinical management are of great interest. The book is subdivided into eight sections the first of which describes the initiation and maintenance of an epidural service. Medical staffing and the role of the midwife frequently presented difficulties and it is emphasised that close co-operation is essential if a safe and satisfactory service is to be established. The need for a resident anaesthetist, expert in resuscitation techniques, is stressed. The sections on indications and fetal welfare suggest that this form of pain relief is applicable in almost every situation providing benefits for mother and infant. The paper presented by Thorburn and Moir dealing with severe pre-eclampsia indicates a need for caution as these authors suggest extradural analgesia may indeed be contraindicated in such circumstances. Ot)her sections deal with the choice of local anaesthetic, extradural management for Caesarean section and complications. Two deaths are mentioned and the importance of good organisation and strict constant medical supervision are stressed. The re-awakening of interest in the use of subarachnoid block in obstetrics is satisfied by a chapter on spinal anaesthesia. This book is essential reading for all associated with the practice of extradural anaesthesia in obstetrics, be they obstetricians, anaesthetists or midwives. It is unique in that it is an appraisal of ten years' work and as such can only aid the advancement and interest in this form of pain relief. The editor, Andrew Doughty, has already made a very significant contribution to safe obstetric anaesthesia and we are again indebted to him for his work on this publication. At the price of £7.50 it represents excellent value. J.M.