The incidence of gastro-oesophageal reflux in children undergoing general anaesthesia has not previously been studied. Onehundred-and-twenty children (ASA Class 1-2) were studied intraoperatively using continuous oesophageal pH monitoring. The incidence of reflux was 2.5% (3 of 120). None of these three patients had an adverse respiratory event. There was no correlation between reflux and adverse respiratory events. Thirteen patients had minor respiratory events without evidence of acid reflux. Gastro-oesophageal reflux does occur in healthy paediatric patients having minor surgery, but was not a significant cause of the adverse respiratory events that occurred in our study.
This 250-page text is well presented and readable. There are occasional figures and helpful diagrams to illustrate the points being discussed. Importantly, there are many tables that provide logical lists and algorithms for daycare institutions. These tables break up the text and provide a helpful focus. There are 10 chapters covering all aspects of anaesthesia for day surgery in a concise and readable fashion. There is an excellent analysis and discussion of efficient anaesthetic management in the day surgery setting. Analgesia and anti-emetic options and recommendations are well presented, with up-todate information on most of the latest drugs, e.g., tramadol, 5HT3 antagonists and COX 2 inhibitors. Protocols for a day surgery unit are included, covering admission and discharge, and algorithms for recovery problems. The book is relevant to Australian and New Zealand practice. Most of the issues covered would help in the management of inpatients as well as day surgery patients. On the downside, the chapters are concise overviews of each topic, and therefore, of necessity, cannot be overly thorough. This text is more for the practising anaesthetist or senior registrar who is already familiar with the techniques and pharmacology, but who wishes to consolidate or fine-tune their practice. However, it is by no means daunting. The text would also be highly recommended for a consultant/manager who was setting protocols for their day surgery unit. At £30 ($A90) you may not wish to buy it for your own library, but I would recommend it for the library of any day care unit or anaesthetic department involved in day surgery.
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