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They include prematurity, Cilengitide the presence of congenital lesions or syndromes, disease processes particular to neonates (necrotizing enterocolitis, patent ductus arteriosus), a narrow margin for error��especially with drug administration and dilution, correct placement of the endotracheal tube, and difficulty with vascular access. Infants of Everolimus in vitro with the greatest gap in pharmacological Palbociclib solubility dmso understanding, and this includes the role of TIVA [6]. Practitioners worldwide take the responsibility for routinely using many medications off-label in their daily clinical practice, and most medications for this age group are prescribed in this way. Clinical trials are increasingly difficult to perform, and most clinicians rely on case reports and expert opinion for guidance in neonatal prescribing. Off-label use may include using the agent for an unregistered indication, route of administration, dose, and/or age group of the patient. For most anesthesiologists in clinical practice, it is a relief to know that ��Off-label pharmacological use is ubiquitous, legal and ethical�� [9]. In an analysis of critical incidents relevant to pediatric anesthesia, medication issues predominated, with the duplication of dosing between the operating room and the wards being the most common in this study [10]. This emphasizes the need for good documentation and communication between these two areas of perioperative care. Drug substitution and dosage errors in pediatric anesthesia in general have been found to be more common than in a comparative adult population [11]. Avoiding errors when diluting drugs, and making mistakes when administering them, requires on-going vigilance and meticulous attention to detail.