Hadzic Regional Anesthesia Pdf Free Download

This is the second edition of a text first published in 2004 by Admir Hadzic, well known as the inspiration behind the New York School of Regional Anesthesia. The book is divided into eight sections.

Section 1—the foundations of peripheral nerve blocks—comprehensively covering the basic principles of regional anaesthesia in 10 chapters. Of note, separate chapters are dedicated not only to the pharmacological principles underlying the regional anaesthesia but also to the fundamentals of everyday aspects of modern clinical practice. For example, inclusion of a separate chapter (Chapter 4) describing the neurophysiology of electrical nerve stimulation is welcome. It recognizes that nerve stimulation still has a role within regional anaesthesia, as not all nerves are visible and access to ultrasound technology may be limited. Monitoring and documentation (Chapter 5) brings all modalities together, including pressure monitoring, as a helpful flow chart designed to help prevent intraneural injection. Chapter 8 is a short but informative chapter providing a summary of the guidelines on anticoagulants and neuraxial blocks. Table 8-1 is particularly helpful in rationalizing the use of commonly used anticoagulants and the new Xa inhibitors (fondaparinux and rivaroxaban) and thrombin inhibitors (desirudin and dabigatran).

Section 2 describes all the common upper and lower limb blocks traditionally performed without ultrasound guidance. In each chapter, several photographs are provided to guide the reader and are supplemented by photographs of cadaver dissection. The strength of these chapters is the setting out of goals and the inclusion of several key tips which aid the reader in achieving these goals. Decision-making algorithms in each chapter are particularly helpful.

Only once the reader is familiar with the fundamentals, are they introduced to ultrasound-guided regional anaesthesia. Section 4, Foundations of ultrasound-guided nerve blocks, has two chapters describing the physics of ultrasound and a short, but important, chapter on how to optimize the ultrasound image.

The description of ultrasound-guided regional blocks, Section 5, uses photographs showing the placement of an ultrasound probe over a cross-sectional anatomical specimen. These photographs are particularly useful as the anatomical relationship between nerves, blood vessels, muscle, and ultrasound probe can be readily seen. Ultrasound scans are clear. The authors have endeavoured to match B-mode images with cross-sectional images.

Ultrasound of neuraxial and perineuraxial structures may be exacting, even to the expert regional anaesthetist. Section 6 presents several B-mode images of the spine matched to reconstructed CT slices. However, more directly applicable to real-time regional anaesthesia is paravertebral block (Chapter 45). The increasing attention being given to the association between plasma levels of local anaesthetic and longer remission of cancer gives added importance to the teaching of this very effective but vastly underutilized block.

Section 7—an atlas of ultrasound-guided anatomy—is particularly good. For each block, a photograph of transducer position, an unlabelled B-mode image, a labelled B-mode image, and an anatomical cross-section is provided.

The new edition builds on the success of the first edition. It does so, not by providing an atlas of ultrasound-guided regional block, but by emphasizing the fundamental principles on which regional anaesthesia is based. Ultrasound can only be applied once these fundamentals are known and practiced, and the overall tone of the book reflects that. The author states that where best practice was not known, anatomy was emphasized, rather than recommend a block. We wholeheartedly recommend this book.