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Series editors Andrew S C Rice, Carol A Warfield, Douglas Justins, and Christopher Eccleston. Published by Edward Arnold Publishers, London, 2002, vol 1: pp 512, £250. ISBN 0-340-80992-2; vol 2: pp 505, £130. ISBN 0-340-80995-7; vol 3: pp 407, £130. ISBN 0-340-80994-9; vol 4: pp 660, £150. ISBN 0-340-80993-0
In the preface to this four volume set of books on pain, the editors are quick to state that they do not see their work as a replacement for the (highly regarded) Wall and Melzack Textbook of pain, but as complementary to it. By placing emphasis on management, they have largely succeeded in this objective. No doubt, the editors and publisher will hope that many will want to own all four volumes in the set. Wisely, however, they have recognised the broad divisions within clinical practice and have separated the books into acute pain, chronic pain, and cancer pain, with a fourth book entitled Practical procedures and applications.
A welcome innovation is a standardised system for scoring the quality of clinical evidence in the papers referred to by chapter authors, recognising that this varies in its reliability. This will be particularly helpful to the naive reader, and is applied throughout all four volumes. In addition, important primary papers and reviews are selected and marked in the reference lists. The great majority of the chapters are well referenced, and although the asterisks following the references in the text at first seem fussy, one quickly gets used to this and appreciates the value of the system. There is also good cross referencing between the volumes. Throughout, the editors have encouraged an evidence-based approach, and where this is limited, there is an attempt to describe current best practice. Many of the therapeutically orientated chapters contain useful guidelines or treatment algorithms.
There is a degree of overlap and duplication, particularly between the volumes on acute pain and practical procedures and applications, and to a lesser extent some topics in acute pain and chronic pain. This was bound to be the case with books intended to stand alone as well as being sold as a set. However, this does not matter, and indeed it is helpful to have more than one view on some of these important topics.
Acute pain starts with basic physiology and pharmacology, but includes under the heading of basic considerations, clinical assessment and pain measurement, outcome measures, and the organisation of an acute pain service. These generic chapters sit well together. There follow chapters on techniques of acute pain treatment, and then 13 chapters on a variety of common clinical situations calling for acute pain relief.
Practical applications and procedures contains sections on principles of measurement and diagnosis, pharmacological therapies (clearly some overlap in these two sections with acute pain), and several sections (including some 25 chapters) dealing with a wide range of therapeutic interventions. There follows a very useful section on the organisation and interpretation of clinical trials (it could be argued that this might have appeared earlier in the volume). Finally, in an honest recognition of the fact that things do not always go well and not all patients are happy with their treatment, there is a chapter on medicolegal issues.
The many topics particular to the management of pain in patients with cancer are comprehensively and clearly dealt with in the third volume in the series. In addition to the predictable subjects covered, there are welcome chapters on epidemiology of cancer pain, psychological evaluation of the patient and family, the importance of effective team working, ethical issues, and complementary therapies.
Perhaps not surprisingly, Chronic pain is the largest volume in the series. An extensive section on basic considerations includes, inter alia, chapters on evidence from experimental animal models of neuropathic pain, epidemiology, clinical assessment, psychology, and as in the first volume, medicolegal aspects in patients treated for chronic pain. The second section reviews the many treatment modalities used for chronic pain, and the third section details particular clinical conditions and situations (20 chapters). Neuropathic pains figure prominently here, reflecting their importance in clinical practice.
The quality of writing and clarity of presentation throughout these books is high, and the four series editors and nine additional individual volume editors are to be congratulated on marshalling over 200 contributing authors. They have succeeded in their objective of producing a very practically orientated approach for clinicians, but not at the expense of skimping on the essential basic science; most clinicians should find the balance about right. The cost of all four volumes is £250; those wanting to buy one of the three volumes (acute, cancer, or chronic pain) will also get the generic book on practical applications and procedures thrown in (price £130–£150). Either way, this represents good value.
Together, the books represent a major addition to the pain literature and an important new resource for pain clinicians; they deserve to do well in an increasingly competitive market. The full series should find a place in all medical libraries as a work of reference. I suspect the editors will be facing the prospect of preparing a second edition before too long. This first edition is highly recommended.
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