Reviews of Educational Material  |   April 2016
Miller’s Anesthesia, 8th Edition
Author Notes
  • University of Virginia Health System, Charlottesville, Virginia (E.C.N.).
  • (Accepted for publication December 17, 2015.)
    (Accepted for publication December 17, 2015.)×
Article Information
Reviews of Educational Material / Airway Management / Education / CPD / Neuromuscular Diseases and Drugs / Obstetric Anesthesia / Patient Safety / Pharmacology / Radiological and Other Imaging / Regional Anesthesia / Quality Improvement
Reviews of Educational Material   |   April 2016
Miller’s Anesthesia, 8th Edition
Anesthesiology 4 2016, Vol.124, 977-978. doi:
Anesthesiology 4 2016, Vol.124, 977-978. doi:
Considered by many to be the definitive resource for anesthesiologists for decades, Miller’s Anesthesia now comes to us in its 8th edition. This book continues to gain not only national but also international recognition as the primary textbook in the field of anesthesiology. This newest edition is no exception to the outstanding wealth of information the authors and editors have provided us in the past. Now with 112 chapters and more than 3,500 pages, it is hard to imagine whether any topics exist that are not adequately covered by this newest edition!
With the 8th edition, 10 new chapters have surfaced in an effort to appropriately reflect growth within the field of anesthesiology. The addition of the chapter “Non-Operating Room Anesthesia” highlights the increasing expansion of anesthesia patient care out of the operating room and into various off-site locations. This chapter provides excellent commentary on the unique considerations for anesthesia outside the operating room, whether for relatively simple, noninvasive procedures on relatively healthy patients or extraordinarily complex procedures for patients deemed “too sick for surgery” in the traditional operating environment. Recommendations for ensuring the same level of safety and standardization in these remote locations compared with anesthetic management in the traditional operating room setting are also provided in this chapter.
Another such chapter, “Perioperative Management,” provides insight into expanding roles as the modern anesthesiologist takes on more responsibility preoperatively and postoperatively to both improve patient outcomes and reduce overall cost. This chapter discusses emerging ideas, such as the perioperative surgical home1  and enhanced-recovery after surgery2  protocols. Other intriguing chapter additions to the textbook include “Anesthesia for Fetal Surgery” and “Administration of Anesthesia by Robots.”
In addition, a few sizeable chapters from previous editions were fittingly split into two separate chapters. For instance, the chapter “Pharmacology of Muscle Relaxants and their Antagonists” from previous editions was divided in the 8th edition into a chapter dedicated solely to the muscle relaxants themselves and a separate chapter devoted to their reversal agents. Similarly, the 8th edition assigns individual chapters to neuromuscular disorders and malignant hyperthermia, important topics that had previously appeared in the same chapter. By dividing such topics, the editors were able to include new authors, thereby gaining valuable, fresh perspectives on these important subjects.
The online content has also expanded. Readers may continue to access the book online through Elsevier’s Web site. The site also offers a total of 19 videos, almost half of which are related to patient positioning. The remaining videos focus mostly on ultrasound-guided nerve blocks and various airway management techniques. The online format of this newest edition is also incredibly user-friendly when accessed through tablet computers (iPads) and smartphones.
Miller’s Anesthesia continues to serve as the definitive reference in the field of anesthesiology. While the chapters continue to grow in quantity, it is readily apparent that the editors have worked hard to ensure nothing has been sacrificed in quality or timeliness of the content. Once again, their dedication to providing us with such an invaluable resource should be applauded.
That said, the million-dollar (or rather, $449) question is, “Does it make sense to buy ANY medical textbook in 2016?” Indeed, in the world of instant online access to the most up-to-date information using Google, Wikipedia, Khan Academy, UpToDate, OpenAnesthesia, Anesthesia Illustrated, New York School of Regional Anesthesia (NYSORA), Coursera, and EdX where the user can quickly find expert, and, in many cases, peer-reviewed medical information at little to no cost, a simple textbook (even one available online) may seem unnecessary. Is a textbook still a valuable investment in a world where the reader can scour Internet to find the answer to almost any imaginable basic or clinical question? We think the answer to this question remains a resounding, “Yes.” The 8th edition of Miller’s Anesthesia brings everything together in a package that is simply greater than the sum of its parts. We do not think we could practice anesthesiology without it and believe its purchase should still be compulsory for all new residents.
Nevertheless, we live in the age of information and technology. The world is changing quickly, and many have predicted the demise of traditional textbook publishing. With this in mind, we challenge the editors of Miller’s Anesthesia to keep the series relevant. We challenge the Editors to be innovative. We look forward to reviewing the 9th edition.
Support was provided from institutional and/or departmental sources.
Katherine T. Forkin, M.D., Edward C. Nemergut, M.D. University of Virginia Health System, Charlottesville, Virginia (E.C.N.).
Kain, ZN, Vakharia, S, Garson, L, Engwall, S, Schwarzkopf, R, Gupta, R, Cannesson, M The perioperative surgical home as a future perioperative practice model.. Anesth Analg. (2014). 118 1126–30 [Article] [PubMed]
Thiele, RH, Rea, KM, Turrentine, FE, Friel, CM, Hassinger, TE, McMurry, TL, Goudreau, BJ, Umapathi, BA, Kron, IL, Sawyer, RG, Hedrick, TL Standardization of care: Impact of an enhanced recovery protocol on length of stay, complications, and direct costs after colorectal surgery.. J Am Coll Surg. (2015). 220 403–43 [Article]