Drug Infusions in Anesthesiology, 2nd Edition

Robert J Fragen, ed.


Reviewed by:
Andre M DeWolfe, MD
Department of Anesthesiology
University of Pittsburgh School of Medicine
Pittsburgh, PA 15213
amd@med.pitt.edu

Drug infusions in Anesthesiology is intended to inform anesthesiologists about the recent advances in drug infusion regimens. The book is separated into three parts: the first part (2 chapters) discusses the general principles of drug infusions and intravenous drug delivery systems; the second part provides more specific information regarding the infusion of specific drugs (intravenous anesthetics, opiates, muscle relaxants) and a discussion on total intravenous anesthesia; and the remainder of the book discusses infusions for the management of postoperative and labor pain, drug infusions in pediatric anesthesia, and infusions of vasoactive drugs.

The first two chapters should allow the reader to understand the principles of drug infusions and apply the rest of the information in this book. Although recent concepts such as "context-sensitive half-time" have been included in both chapters, the information provided is still incomplete. For example, few formulas are provided or explained to calculate drug transfer in two- or three-compartmental models. Also, the definition of keo is contradictory in both chapters. Concepts such as cumulation and time to achieve steady-state concentration after a continuous infusion are not discussed at all, although they are mentioned later in the book. There is also considerable overlap in these two chapters, because the second chapter (drug delivery systems) includes a discussion on basic principles. I feel that combining much of the information in these two chapters would be beneficial and would allow for a more complete discussion of the principles.

The middle part of the book (infusion of intravenous anesthetics, opiates, and muscle relaxants, and total intravenous anesthesia) is very informative and provides a wealth of practical information. This is where the clinician will obtain guidelines on how to use continuous infusions of anesthetics. The third part of the book discusses infusions for the management of postoperative and labor pain, drug infusions in pediatric anesthesia, and infusions of vasoactive drugs. Two of these chapters (management of postoperative and labor pain, and infusions of vasoactive drugs) seem somewhat out of place in this book. Still, the information that is provided is valuable.

In summary, Drug infusions in Anesthesiology provides sufficient information to understand most principles of continuous infusions and to apply these principles clinically. Infusions of anesthetics are more common today, and at times total intravenous anesthesia is the technique of choice. Therefore, I feel that this book is of value to every clinical anesthesiologist.


Drug Infusions in Anesthesiology, 2nd edition. Robert J. Fragen, ed. Lippincott-Raven, Philadelphia, New York, 1996, ISBN 0-7817-0265-8, 283 pp.