Eur J Anaesthesiol 2018; 35:240–241
BOOK REVIEW
Ultrasound in Anesthesia, Critical Care, and
Pain Management
Published online 22 December 2017
G Arthurs & B Nicholls
Cambridge University Press: Cambridge, UK; 2016
360 pages
ISBN 978-1-107-61832-9
Ultrasound in Anesthesia, Critical Care and Pain Management
is the second edition of the textbook originally published
under the title Ultrasound in Anesthetic Practice in 2009.
This revised edition by Drs Arthurs and Nicholls has
been expanded and updated to include the use of ultra-
sound within pain and airway management, including
contributions from 26 authors with varying clinical back-
grounds.
The original title was published during a time when the
interest in ultrasound amongst anaesthetists was under-
going a rapid increase, particularly with the potential
advantages for regional anaesthesia and vascular access.
Although initial uptake may have been slow, critical care
use of both ultrasound and echocardiography is expand-
ing quickly in part due to the development of focused
accreditations such as Focused Intensive Care Echocar-
diography (FICE) and Core Ultrasound in Critical Care
(CUSIC). Ultrasound is certainly becoming embedded as
a core competency amongst anaesthetists, critical care
and pain physicians.
The editors have remained faithful to their original
layout, covering all potential applications of ultrasound
to the practice of anaesthesia with the addition of two
new chapters. Rather than a DVD, access to an on-line
version of the textbook is available providing colour
versions of most figures, additional figures not included
in the book and videos of varying quality and relevance.
The introductory chapter explains the physics of ultra-
sound concisely and is surprisingly easy to read for such a
challenging topic. Ultrasound to aid vascular access covers
the indications for, advantages and evidence behind the
use of ultrasound for vascular procedures. There was
definite scope to develop this chapter further with the
inclusion of ultrasound-guided subclavian and peripher-
ally inserted central catheter (PICC) access.
The echocardiography chapters may provide a chal-
lenge to the non-cardiac anaesthetist. They are,
0265-0215 Copyright ß 2018 European Society of Anaesthesiology. All rights reserved.
Copyright © European Society of Anaesthesiology. Unauthorized reproduction of this article is prohibited.
however, well written and supplement the knowledge
obtained through focused echocardiography courses.
The eight case summaries provided are of relevance
to the pre-operative recognition and assessment of
patients with potential cardiac co-morbidities. Both
transthoracic (TTE) and transoesphageal (TOE) echo-
cardiography are included interchangeably which could
provide some confusion to the novice sonographer. A
separate chapter covering TOE would be justified in
view of its increasing perioperative and critical care
usage.
The chapters that follow include the use of ultrasound
in critical care, trauma and airway assessment. The
airway assessment chapter is particularly interesting,
discussing the potential benefits of ultrasound for intu-
bation, emergency front of neck access and tracheos-
tomy. The chapters on regional anaesthesia are
subdivided into adult and paediatric sections. The
anatomy is first summarized, followed by procedural
descriptions. These chapters need to be read in com-
bination with the on-line material, which provide larger
illustrations than the textbook.
Apart from the concluding chapter on pain management,
the remaining chapters including cranial ultrasound in
the newborn, acute gynaecology and pregnancy, ocular
ultrasonography and assessment of soft tissue injuries are
interesting but likely to be beyond the practicing scope of
most anaesthetists.
The use of ultrasound has certainly progressed since
the first edition of this textbook. Although providing
a relevant overview of the importance of ultrasound
within anaesthesia, critical care and pain medicine,
it suffers somewhat from an attempt to satisfy all.
Whilst not providing sufficient detail to act as a refer-
ence textbook, the quality of the images are sub-opti-
mal for it to act as a ‘pocket’ guide. Despite being a
revised and updated edition, it is disappointing that
the second edition continues to be let down by its
illustrations.
Overall Ultrasound in Anesthesia, Critical Care, and Pain
Management is a very readable introduction to the
practical use of ultrasound, providing an emphasis on
image acquisition and optimisation. In combination
DOI:10.1097/EJA.0000000000000764
 Book review 241

with the on-line material, it provides a valuable aid in
understanding how ultrasound techniques are utilised
within our practice. Despite its multidisciplinary
authorship, the extensive but broad review may not
appeal to all. There are an increasing number of
ultrasound texts providing high-quality images and
videos within more specific areas of practice. These
may be a more relevant and informative read for the
physician working within focused areas of anaesthesia.
Dr Alastair Morgan
Consultant in Anaesthesia & Critical Care
Sheffield Teaching Hospitals, UK

Eur J Anaesthesiol 2018; 35:240–241

Copyright © European Society of Anaesthesiology. Unauthorized reproduction of this article is prohibited.