Neonatal/Pediatric Anesthesia Standard Dilutions

PLEASE NOTE:   Posts made to this forum should not be considered as the expressed opinions of, nor should be considered endorsed by, the Medication Safety Officer’s Society (MSOS) or the Institute for Safe Medication Practices (ISMP). 

Make sure your email is up-to-date
In order to continue to receive updates from MSOS, as well as forum posts and other valuable information as a member of MSOS, please be sure to update your email address with us, whenever it changes. If you need assistance doing so, please send an email to cmichalek@ismp.org. 

1 post / 0 new
Log in or register to post comments
Thu, 08/06/2026 - 16:05
#1
Lauren Gashlin
Lauren Gashlin's picture
Offline
Last seen: 1 week 12 hours ago
Joined: 12/08/2014 - 09:22
Neonatal/Pediatric Anesthesia Standard Dilutions

We have a children's hospital embedded in an academic medical center with shared pharmacy services. Our pediatric anesthesiologists are asking for pharmacy-prepared anesthesia medications in safer/more practical concentrations for neonates/small pediatric patients in the setting of OR preparation/administration errors. For example fentanyl is commercially available only as 50 mcg/mL so must be diluted to measure a 3 mcg dose.

Interested in how other hospitals that provide neonatal surgeries manage this. Are there standard dilution concentrations? Do Anesthesia providers order in advance, patient-specific or are these concentrations batched and stocked in pediatric ORs?

Specific drugs we are exploring:
Fentanyl
Ketamine
Rocuronium
Epinephrine
Atropine

They are not requesting continuous infusion syringes, though that might be one way to manage this, I have reviewed ASHP S4S and Vermont Oxford Network as resources for standard concentrations.

Appreciate any responses!
Lauren

Top