Fundamentals of Anaesthesia and QBase Anesthesia 6

With the second edition of Fundamentals of Anaesthesia, Pinnock and coworkers present a textbook for residents in anaesthesia to use to prepare for the Primary FRCA (Fellowship of the Royal College of Anaesthetists) examination. In many aspects, it is difficult to negotiate the fine line between clinical handbook and extensive textbook. Combining the individual areas (i.e. physiology, pharmacology, clinical pathways, etc.) into one book is a complex task but one that is required to meet the needs of examination candidates. Fundamentals of Anaesthesia achieves its ambitious goal of addressing all areas of interest, and it serves as a very useful tool in the review process before the examination.

The book is well organized within each chapter and advances between chapters (and topics) in a logical manner. In an easy-to-read text format, even the most difficult and complex areas are rendered understandable, with take home messages highlighted for further review. Whereas chapter 1 serves as an impressive introduction, touching on all important areas routinely encountered in daily peri-operative practice, chapters 2 and 3 provide in-depth coverage of the underlying principals of pathophysiology and pharmacology. Nevertheless, the reader never gets the impression that they are reading a single textbook on either pharmacology or pathophysiology because the clinical relevance of the content is always made clear. The chapters are clearly orientated to the needs of the anaesthetist and explain what is essential in understanding the underlying principals of routine practice.

Additional information is given about useful competencies in areas such as management, leadership, and social and ethical dilemmas. The last chapter concentrates entirely on physics, basic statistics and clinical measurement.

However, medical knowledge changes quickly, and the comprehensive textbook is not up to date in a few sections (e.g. topics on preoperative starvation, peri-operative β-blockade, and application of antiarrhythmic agents). It will still be necessary for the candidate to review the most recent literature on crucial areas in the field. For this reason, a more up-to-date and consistent format for bibliographic references at the end of each chapter would be helpful to the reader. Additionally, more pictures or detailed graphical descriptions would be helpful in enhancing the reader's understanding of basic anaesthetic techniques.

In summary, we believe that this thorough overview can not substitute for a comprehensive textbook or a clinical handbook, but it serves as valuable tool for reviewing previously acquired knowledge and skills.

The companion book is a collection of multiple choice questions that reflect the content of the textbook. It is meant to be a summary of the textbook as well as a tool to rehearse the format of the multiple choice examination. Questions are supplied with corresponding correct answers and are explained in good detail. However, the quality of the multiple choice questions requires improvement if they are to be used to revise for important examinations. To enhance the quality of multiple choice questions, they should be reviewed and adapted to internationally accepted standards (e.g. using patient vignettes) and provide a different answer format, preferably a 'single, best answer' for reliability reasons [1, 2].