Analgesia: Patient controlled

Information on patient controlled analgesia

Pain is a personal matter. The amount and type of pain relief required varies between people, even for the same type of injury or surgery.

What is PCA?

Patient controlled analgesia, or PCA, is a method of pain control that allows you to give yourself some pain relief as and when you need it. The PCA is used for short-term pain relief of strong pain, usually after major surgery or trauma. The PCA would usually be replaced by alternative pain relief medicines after a few days or once you are able to have medicines by mouth.

Patient Controlled Analgesia

How does a PCA work?

The PCA system is attached to you through an infusion into a vein in your arm. You control the system with a handheld device with a button; other ways of activating the system are available if you do not have full use of your hands. When you feel pain, you should push the button on your PCA handset and a small amount of pain relief will be delivered directly into your bloodstream. A reduction in pain should be felt within a few minutes; if not you can press the button again once the red light is visible on the handheld device.

Who controls the PCA?

You are the only person who knows when you are in pain so you are the only person who should press the PCA button.

Is PCA safe?

The PCA has alarms set to alert your nurse of any problems. It is carefully programmed to deliver only a specific amount of pain relief.. The nurses and doctors will follow your progress carefully. There will be frequent checks on your blood pressure, pulse, breathing and level of sedation.

If you have a PCA, you must not leave the ward without being accompanied by a trained member of staff.

Is the PCA pain relief addictive?

When used for a short period of time only, the pain relief via the PCA is not addictive. Pain control is important to help you to mobilise, deep breathe and cough; reducing the risk of developing a chest infection or deep vein thrombosis. Good pain control can also reduce your hospital stay.

Can I take paracetamol alongside the PCA?

It is strongly recommended that you take regular paracetamol as prescribed by your doctor or non-medical prescriber, unless there are any contraindications. When paracetamol is given alongside PCA, this can enhance its analgesic effects, thus, reduce the amounts of opioids administered.

Your part in controlling pain

Your nurse will ask you to rate your pain using numbers, words,using an assessment chart with faces on it. This assessment will indicate the amount of pain you are experiencing. Using numbers, pain would be scored as follows.

0 no pain

10 worse pain imaginable

Your reports will help the nurses and doctors to make necessary adjustments to your care.

It is realistic to expect some pain when coughing or moving about in bed, but it should never be more than mild (bearable). Pressing the PCA button before mobilising, deep breathing or coughing will help to prevent your pain level from rising. Use your PCA to keep your pain level in the mild and bearable range (score 0 – 4) just before and during movement.

Are there any side effects?

All drugs have some side effects. The most common side effects with a PCA are nausea and vomiting, itching, drowsiness and constipation; however, this list is not exhaustive. You may be offered a laxative when you are using a PCA. You should also have a medicine prescribed that you can ask for if you feel sick. Please speak to your nurse or doctor if you wish to discuss this further. Side effects do not occur in everybody. If they occur, report them to the nurse or doctor looking after you.