What is Patient-Controlled Analgesia?

Controlling pain in hospital settings is done in a number of ways. Doctors may leave orders with nurses, for instance, to give a shot or injection of a pain-reliever in an intravenous (IV) line once every few hours. Alternately, medication in oral or injected form might be available upon request of the patient. Neither of these methods is perfect, and in the 1970s the idea of letting patients have access, in limited form, to pain medication began to emerge as a popular one. Called patient-controlled analgesia (PCA), patients don’t have to wait for nurses and can instead press a small button to deliver medication straight into an IV for quick pain relief.

Though not always appropriate, patient-controlled analgesia may be of great use in a number of circumstance, and it can even be used by children old enough to understand it. A small pump has a certain amount of pain-relieving medication stored in it, and this is typically connected to an IV inserted into the patient’s body. When pain is felt, the patient usually has direct access to a button controlling the pump and may depress it for a dose of pain medication. This circumvents the process of having to wait for pain relief while a busy nurse can get to the patient, or it may avoid having to wait for a doctor’s order while being in extreme pain.

The potential pitfall of patient-controlled analgesia is easy to see. Couldn’t a patient accidentally overdose by repeatedly pressing the button, especially if that patient is a child? Safety features built into the pump avoid this.

Pumps can be programmed so that a specific amount of medication is dispensed within a certain time period. Once that amount is reached the pump will lock out. At that juncture a patient might still require additional medication or a different type. It would usually be given on doctors’ orders only.

These safety features are rarely compromised, but a hospital with equipment problems could have some issues. Sometimes batteries in machines are overused and a machine could stop working, rendering patient-controlled analgesia useless. Usually pumps start to beep loudly if they are running short on battery power; plugging them into a wall, or using a different pump can solve this issue provided it is noticed.

One of the major selling points of PCA is that it keeps patients from waiting. This is an important consideration in pain management. Most pain control is more effective if administered when pain is lower. Greater amounts of discomfort may not be as well controlled when people have to wait, and this can mean a patient needs more medication than they ordinarily might to achieve relief.

On the flipside, pain control that doesn’t feature continuous drip into an IV can be an issue when a patient isn’t awake for long periods at a time. Patients could awake to severe pain. To counter this occurrence, a small amount of medication could be continuously given, and control of greater amounts is still up to the individual.

There are other forms of patient-controlled analgesia. Anybody who has ever taken ibuprofen, acetaminophen, or other pain medications at home has experienced them. These don’t have the same safety feature, as is built into PCA pumps in hospitals.

Specifically, people using medications at home don’t have any limits or lockouts on the amount of medication they can take, which is occasionally problematic. In order to build in the same safeguards, people really must adhere to instructions for safe amounts of medicines to take at home. If pain continues, seeing a doctor for additional guidance makes good sense.