Personnel working in the operating room complex may be at increased risk for chemical impairment. It has been proposed that this predisposition may be related to the frequency of use of controlled substances and the inadequate control over distribution of these medications, which frequently exists in the operating room. A system utilizing a pharmacy satellite in the operating room has increased the control and accountability of drug administration practices. Several other alternative systems are also reviewed. Emphasis is placed on the establishment of a quality assurance program to monitor compliance routinely.

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