Patient-controlled analgesia

Patient-controlled analgesia (PCA) is any method of allowing a person in pain to administer their own pain relief. The infusion is programmable by the prescriber. If it is programmed and functioning as intended, the machine is unlikely to deliver an overdose of medication. Providers must always observe the first administration of any PCA medication which has not already been administered by the provider to respond to allergic reactions. The most common form of patient-controlled analgesia is self-administration of oral over-the-counter or prescription painkillers. For example, if a headache does not resolve with a small dose of an oral analgesic, more may be taken. As pain is a combination of tissue damage and emotional state, being in control means reducing the emotional component of pain. In a hospital setting, an intravenous PCA (IV PCA) refers to an electronically controlled infusion pump that delivers an amount of analgesic when the patient presses a button. IV PCA can be used for both acute and chronic pain patients. It is commonly used for post-operative pain management, and for end-stage cancer patients. Narcotics are the most common analgesics administered through IV PCAs. It is important for caregivers to monitor patients for the first two to twenty-four hours to ensure they are using the device properly. With an IV PCA the patient is protected from overdose by the caregiver programming the PCA to deliver a dose at frequent set intervals. If the patient presses the button sooner than the prescribed intake pressing the button does not operate the PCA. (The PCA can be set to emit a beep telling the patient a dose was NOT delivered). The inability of an obtunded patient to push the button is also considered an inherent safety feature of PCA. Patient-controlled epidural analgesia (PCEA) is a related term describing the patient-controlled administration of analgesic medicine in the epidural space, by way of intermittent boluses or infusion pumps. This can be used by women in labour, terminally ill cancer patients or to manage post-operative pain.