Patient controlled analgesia (PCA) - information for parents / carers

Children who have good pain management tend to recover faster. This leaflet contains information about:

• What a PCA is.
• What side-effects to look out for.
• How a PCA manages your child’s pain safely.

What is a PCA?

PCA stands for Patient Controlled Analgesia. This is a type of pain relief that lets your child control how much pain medicine is needed. Your child can give themselves a small amount of pain medicine by pressing a button. The pain medicine we usually use is called Morphine but there are other pain medicines that are related to Morphine that may be used.. The prescriber will decide which one is best for your child. All the pain medicines used in the PCA are strong which will help to reduce your child’s pain.

How does it work?

A PCA machine contains pain medication in a syringe; this is connected to a tiny tube called a cannula. This cannula may be put in whilst they are in the operating theatre. Connected to the machine is a handset with a button on it. When your child has pain, they can press this button and the machine will give a small amount of pain relief medicine through the cannula and into the vein. The machine may also be set so that a small continuous amount of pain-relieving medicine is given all the time, in addition to the doses given when the button is pressed. The machine will be set for your child according to the prescriber’s orders.

Is a PCA safe?

Yes, but it is very important that your child is the only person who presses the button. This is because your child is the only one who knows when pain relief is needed.

If someone else presses the button your child may become too sleepy and very unwell. Your nurse will be checking their heart rate, breathing, pain level and how sleepy they are every hour. The nurse will ask your child about their pain using a pain assessment chart that is appropriate for their age and ability.

Can my child press the button as often as they require?

Yes. The machine has been specifically set by the prescriber so that it will lock for a short period of time after the button has been pressed. This is so the pain relief medication is given time to work before your child can get some more, and to help stop your child from having too much pain medication and becoming too sleepy.

How will the PCA make your child feel?

Some children have said that they feel itchy or sick. It is important that you or your child let the nurse know how they are feeling so that the nurse can give them other medicine to reduce these symptoms.

How long will your child need the PCA for?

This will depend on your child’s pain or the type of operation or illness your child has . As your child gets better the need to press the button will be less. Your child will be given other pain medicine such as Paracetamol alongside the PCA. When your child’s pain is improving and they can have other pain medicines, the PCA will be stopped.

Before stopping the PCA the nurse will ask your child questions about their pain to make sure that it is appropriately managed. Your child will also carry on taking other pain medicines that will help to manage their pain. Your child may need to continue taking pain medicines when they get home.

Will your child get addicted to the pain medication in the PCA?

No. Children do not become addicted to pain relieving medicine as it is being given to manage pain after an operation or illness . Usually, your child will only need the pain medication through the PCA machine for a few days. If the PCA is used for more than a few days your child’s body may become used to the pain-relieving medication. In this case the PCA may need to be reduced slowly.

What do you do if you are worried?

You know your child best and we rely on that knowledge. If you have any worries or questions about your child’s pain management then please talk to the nurse. You could also ask your child’s nurse to call the children’s pain team or an anaesthetist to come and talk to you.