This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Windokun, A. Search for Related Content PubMed PubMed Citation Articles by Windokun, A.

---

LETTER TO THE EDITOR

Database Analysis of Atypical Drug Transactions

Department of Cardiothoracic Anesthesia; The Cleveland Clinic; Cleveland, Ohio; jare{at}windokun.net

To the Editor:

Epstein et al.1 suggest that screening methods may prevent diversion of controlled substances. In hospitals that use an anesthesia information management system (AIMS), anesthesiologists recognize that obvious diversion of drugs can lead to an immediate inquiry. Anesthesiologists intent on diverting medications may record a larger amount of medication than was actually administered and thus avoid discrepancies in both the anesthetic and medication record. This may result in a reduction in the number of errors documented in an AIMS, but not necessarily signify a reduction in actual diversion. It is therefore, not surprising, that the authors have not been able to identify any diversion in 8 mo.

Because the consequences of certain behaviors may be noteworthy, the effect of this analysis on patient care should be noted. For example, anesthesiologists could conceivably administer the mean doses of narcotics rather than the dose required by the patient so as not be an outlier. Alternatively, the anesthesiologist may be more likely to administer full doses of narcotics so as not to have to document any wastage. The authors, by not enumerating other methods of diversion for fear of providing insight to those diverting drugs, are missing the point that such individuals have a much stronger motivation to discover new ways to divert drugs.

REFERENCE

1. Epstein RH, Gratch DM, Grunwald Z. Development of a scheduled drug diversion surveillance system based on an analysis of atypical drug transactions. Anesth Analg 2007;105:1053–60[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Windokun, A. Search for Related Content PubMed PubMed Citation Articles by Windokun, A.