Patient-Controlled Analgesia Pumps
Patient-controlled analgesia (PCA) is
a type of pain management that lets you decide when you will get a dose of pain medicine.
In some cases, PCA may be a better to ease pain than calling the nurse to give you pain
medicine. With PCA you don't need to wait for a nurse You can get smaller doses of pain
medicine more often.
With this type of pain treatment, a
needle attached to an IV (intravenous) line is placed into your vein. A computerized pump
attached to the IV lets you release pain medicine in prescribed intervals by pressing a
hand held button.
PCA can be used in the hospital to
ease pain after surgery. Or it can be used for painful conditions like pancreatitis or
sickle cell disease. It also works well for people who can’t take medicines by mouth. PCA
can also be used at home by people who are in hospice or who have moderate to severe pain
caused by cancer. Children as young as age 7 can benefit from PCA if they understand the
idea behind it, can follow instructions, and are closely monitored. PCA is not advised for
people who are confused, disoriented, or unresponsive.
How PCA works
Your healthcare provider must
prescribe a PCA pump for you. The pain reliever given through the pump will most likely
be an opioid medicine such as morphine or hydromorphone.
This is what you may expect if a
PCA is prescribed for you:
Your healthcare provider will
decide on a starting dose of the pain medicine. He or she will also determine the
dosages you will get each time you press the button, how much time there should
be between doses, and the total amount of medicine you will get over a certain
period of time. This is to keep you from getting an overdose. A low dose of pain
medicine may also be injected continuously for a base level of pain control. All
these specifics will be programmed into the pump, and the pump will record all the
times you press the button and how much pain reliever you are given.
A nurse will make sure you
understand how to use the PCA machine.
Between doses of pain
medicine, IV fluid may flow into your vein to keep it open and keep you well
Your vital signs and oxygen
levels may be checked by monitors at your bedside.
When your pain lessens, you
may be switched to a pain medicine taken by mouth.
You'll need frequent monitoring by
your nurse while you are using the PCA pump. The nurse may need to wake you up to check
for breathing problems and other side effects.
Family and friends staying with you
during recovery should report any concerns of breathing problems or other side effects
to the nurse right away.
Risks of PCA
PCA is often safe and effective.
The main risk is having a reaction to the opioid medicine. Side effects from opioids
You should be watched carefully for
respiratory depression if you:
Are an older adult
Have asthma or other lung
Have sleep apnea
Have not used opioids in the
Need high doses of opioids
for pain relief
If used properly, PCA may reduce
the risks linked to opioids because you are less likely to be over-treated or
under-treated. Make sure that you are the only person who pushes the button for pain
relief. If friends or family members also push the button as a way to help you, there is
the danger that you might get over sedated and have trouble breathing. Also, your
healthcare team should explain to everyone that you don’t have to push the button as
often as allowed. You only need to press it if you need pain relief.