Pain Control An open learning programme for healthcare workers By Nan Stalker Radcliffe Medical Press 117 pages £17

This is an interactive learning workbook on the pharmacology of pain and pain control. Nine sessions cover: revision of neurones;

structure and function of the brain; structure and function of the spinal cord; voluntary and reflex actions; autonomic nervous system; the experience of acute and chronic pain; and the modulation of pain.

The workbook allows the reader to identify current knowledge with the use of competency questions at the beginning of each section. The author recommends repeating this at the end of each section to check learning.

The title states that the book is aimed at healthcare workers, which gives the impression of multiprofessional relevance.

This is probably so, but from section seven onward, the author continually relates to nursing experience. The book would be helpful to those of us who need to brush up on the anatomy and physiology of pain from time to time.

Detailed descriptions of theories, systems and anatomy are given. There are good diagrams, and a section of additional resources, which support some of the theories in more detail. Stalker names previous work, but I found some of the referencing lacking. Bibliographies for additional reading are supplied. An index would have been helpful for consolidation during study.

I recommend the section covering acupuncture as an excellent description of the technique, supported by additional reading later in the book. But it is a pity the author refers to the use of acupuncture according to US law.

The section covering pharmacology of pain is, in the main, helpful. Reference is made to the World Health Organisation analgesic ladder.

The use of non-steroidal antiinflammatory drugs is described with clarity and their mechanisms and contraindications explored. Opioids are explored for their uses, side-effects and derivatives.

Stalker gives a balanced view of the use of morphine, but in my opinion, does not explore its versatility in the control of pain in patients requiring palliation. Much is said about tolerance and dependence, but only a short amount about the wide use of opioids in palliative care. There is brief reference to non-licensed drugs used as analgesia.

Overall, a good learning set for students and a good revision tool for practising professionals in a wide range of settings.