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Reviews of Educational Material  |   November 2007
Ambulatory Anesthesia: The Requisites.
Author Notes
  • University of Alabama, Birmingham, Alabama.
Article Information
Reviews of Educational Material / Ambulatory Anesthesia
Reviews of Educational Material   |   November 2007
Ambulatory Anesthesia: The Requisites.
Anesthesiology 11 2007, Vol.107, 862. doi:10.1097/01.anes.0000287193.39678.c3
Anesthesiology 11 2007, Vol.107, 862. doi:10.1097/01.anes.0000287193.39678.c3
Ambulatory Anesthesia: The Requisites.  By Scott R. Springman, M.D. St. Louis, Mosby, 2006. Pages: 204. Price: $79.95.
Since 2004, the Requisites in Anesthesiology  series has been expanding to include the various divisions and subspecialties that encompass the clinical practice of anesthesiology. Each volume aims to provide a focused, organized, and quickly assimilated review of a particular aspect of anesthesiology. The newest volume to join the series is Dr. Scott Springman’s Ambulatory Anesthesia  . In this installment, Dr. Springman not only manages to achieve the aims of the Requisites in Anesthesiology  series admirably, but expands on them considerably.
For residents and fellows preparing to enter the workforce as well as seasoned anesthesia veterans facing ever-changing clinical practice, the information in Dr. Springman’s text is invaluable. Indeed, with the rapid expansion of ambulatory surgery and office-based anesthesia in the past 10–15 yr, knowledge in the area encompassed herein is certainly “requisite.” This text is organized much like a clinical practice setting is itself organized. Beginning with the selection of patients for outpatient surgery and preoperative evaluation, and moving to selection and administration of an appropriate anesthetic plan, followed by postoperative complication management (including one of the most concise and enlightening chapters on postoperative nausea I’ve read) and discharge criteria, the text mirrors a patient’s journey through our surgical centers. The material is complete in that most anything one would need to know regarding the outpatient clinical setting is covered, but not in the detail that a larger, more comprehensive textbook would offer. This difference is entirely intentional, because this is a review text meant to be easily covered by the reader in a matter of a week or two. The text includes highlighted “key points” and “controversies” as well as case studies to help the reader assimilate material into a practice setting. I did not find the controversy segments to be particularly useful (because I’m old and set in my ways already), but I can easily see how someone facing the daunting task of taking American Board of Anesthesiologists oral boards might benefit from the pros and cons given in those segments. The value of this section lies in the logic and reasoning to support each course of action that is presented, which is invaluable in the oral board setting.
Previous Requisite  texts have been focused on subspecialties, types of surgery, or unique patient populations. This text is quite different in that it infolds into the ambulatory surgical environment elements of all previous topics covered by this series. The scope of ambulatory anesthesia, as a separate clinical entity in and of itself, is broad because it is not just a subspecialty or division, but often a freestanding center and business as well. To address these differences, Dr. Springman ends his text with chapters regarding facility design, accreditation, and management. He furthermore includes appendices with the American Society of Anesthesiologists guidelines for establishing an ambulatory care center. His inclusion of these latter topics is not surprising given his appointment at the University of Wisconsin School of Business and his leadership of the Administrative Medicine Curriculum at the University of Wisconsin.
The scope and practice of ambulatory anesthesia has changed drastically since the development of the first freestanding surgery center in the 1960s. The pace of change in outpatient surgery, driven by economic and social factors, has been so brisk that one might think Dr. Springman should revise Ambulatory Anesthesia  yearly (or even more frequently!). But this text achieves a remarkable feat: It includes all of the specific information needed in the outpatient setting, while remaining general enough that its scope should stand the test of time. Ambulatory Anesthesia  is a valuable addition to the studies of the anesthesia resident preparing for the American Board of Anesthesiologists written and oral boards as well as a valuable resource for every anesthesiologist practicing ambulatory anesthesia.
University of Alabama, Birmingham, Alabama.