Securing Anesthesia Medications

Securing anesthesia medications is critical to prevent misuse and theft and to protect patient safety. Implementing strict protocols and policies that comply with federal and state regulations is essential to managing these potent drugs effectively. Doing so involves multiple strategies, including secure storage, rigorous documentation, education, technological advancements, and fostering a culture of accountability.

Anesthesia medications must be stored securely to prevent unauthorized access. This can be accomplished by using locked drug carts or automated dispensing cabinets (ADCs) that restrict access to authorized personnel. For example, guidelines from the Canadian Journal of Anesthesia emphasize the need for controlled medication storage and recommend secure anesthesia carts and cabinets with limited access (1). Such measures reduce the risk of diversion and ensure that only trained healthcare professionals have access to these medications.

Proper documentation is another important aspect of securing anesthesia medications. Accurate record keeping helps track the use and inventory of these drugs, making it easier to identify any discrepancies. Each dose administered should be meticulously recorded in the patient’s medical record, and regular audits should be conducted to ensure consistency. A quality improvement study of medication diversion highlighted the importance of routine checks and secure handling of narcotic keys to ensure that only authorized personnel have access (2).

Education and training of healthcare personnel is also an essential component of securing anesthesia medications. Staff should be educated about the risks of medication diversion, proper handling procedures, and the importance of following security protocols. The Joint Commission’s Medication Management Standards set expectations for medication security and emphasize ongoing education and training to prevent drug diversion and ensure patient safety (3). Ongoing education ensures that staff are aware of the latest medication management guidelines and best practices.

Technological advances further enhance medication security. The use of barcode scanning and electronic health records (EHRs) can improve the accuracy of medication administration and reduces errors. For example, the integration of anesthesia information management systems (AIMS) provides a comprehensive electronic record of medications administered, improving tracking and accountability (4). These systems can also generate real-time alerts for unauthorized access attempts, further securing the medication management process.

Creating a culture of accountability and transparency within the healthcare team is critical. Encouraging open communication and reporting any suspicious activity without fear of retribution can help identify potential problems early. Implementing anonymous reporting systems can encourage staff to report medication safety concerns. Emphasizing accountability ensures that all staff members understand their role in maintaining medication safety and feel responsible for upholding these standards.

Proper disposal of unused or expired anesthesia medications helps prevent diversion. Following Drug Enforcement Administration (DEA) guidelines and local regulations ensures that medications are disposed of safely and rendered unusable. Ensuring that all unused medications are placed in tamper-evident disposal containers and properly destroyed is essential to maintaining safety and compliance.

In summary, securing anesthesia medications requires a multifaceted approach that includes secure storage, meticulous documentation, ongoing education, technology integration, and fostering a culture of accountability. By implementing these measures, healthcare facilities can significantly reduce the risk of drug diversion and ensure patient safety and regulatory compliance.


  1. Dobson G, Chow L, Filteau L, et al. Guidelines to the Practice of Anesthesia – Revised Edition 2020. Can J Anaesth. 2020;67(1):64-99. doi:10.1007/s12630-019-01507-4
  2. Brindley D, Anderson P, Canales J. Medication Diversion Quality Improvement Study. Accreditation Association for Ambulatory Health Care. 2021.
  3. van Pelt M, Meyer T, Garcia R, Thomas BJ, Litman RS. Drug Diversion in the Anesthesia Profession: How Can Anesthesia Patient Safety Foundation Help Everyone Be Safe? Report of a Meeting Sponsored by the Anesthesia Patient Safety Foundation. Anesth Analg. 2019;128(1):e2-e4. doi:10.1213/ANE.0000000000003878
  4. Simpao AF, Rehman MA. Anesthesia Information Management Systems. Anesth Analg. 2018;127(1):90-94. doi:10.1213/ANE.0000000000002545