title: Review article: improving drug safety for patients undergoing anesthesia and surgery.
abstract: OBJECTIVE
  This article presents a summary of recent advances, including tools and interventions, that are designed to improve drug safety for patients in critical care settings, particularly those undergoing anesthesia and surgery.
  
  
  RESULTS
  Medication error remains a leading cause of adverse events among patients undergoing anesthesia. Misidentification of ampoules, vials, and syringes is a common source of error. Systems are now being engineered to reduce the likelihood of medication misidentification through approaches such as revision of standards for labelling of drug ampoules and vials and the development of bar code systems that allow "double checking" or drug verification in the operating room. Also, efforts are being made to improve medication reconciliation, a process for accurately communicating a patient's medication information during transitions from one healthcare setting to another. Finally, the opportunity exists for anesthesiologists to increase awareness about the rising problem of opioid addiction in patients for whom typical doses are initially prescribed for appropriate indications such as postoperative pain.
  
  
  CONCLUSIONS
  There is a need to improve drug delivery systems in complex critical care environments, particularly the operating room. Anesthesiologists must continue to play a leading role in promoting drug safety in these environments.
authors.affiliation: Department of Anesthesia, Sunnybrook Health Science Centre, University of Toronto, Toronto, ON, Canada. beverley.orser@utoronto.ca
authors.forename: Beverley A
authors.initials: BA
authors.lastname: Orser
authors.forename: Sylvia
authors.initials: S
authors.lastname: Hyland
authors.forename: David
authors.initials: D
authors.lastname: U
authors.forename: Ian
authors.initials: I
authors.lastname: Sheppard
authors.forename: C Ruth
authors.initials: CR
authors.lastname: Wilson
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects; D000758:Anesthesia / Q000009:adverse effects / Q000592:standards*; D000776:Anesthesiology / Q000379:methods / Q000592:standards*; D003422:Critical Care / Q000379:methods / Q000592:standards; D004305:Dose-Response Relationship, Drug; D004348:Drug Labeling; D001330:Electronic Data Processing; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control*; D059065:Medication Reconciliation / Q000592:standards; D008510:Medication Systems, Hospital / Q000592:standards; D009873:Operating Rooms / Q000592:standards; D009293:Opioid-Related Disorders / Q000453:epidemiology; D010149:Postoperative Pain / Q000188:drug therapy
chemical_list: D000701:Analgesics, Opioid