Intravenous PCA for Post-operative Pain Management

Benjamin Vaghari M.D.
Resident Physician of Anesthesiology

Kishor Gandhi M.D., M.P.H.
Assistant Professor of Anesthesiology

Eugene R. Viscusi, M.D.
Associate Professor of Anesthesiology
Director, Acute Pain Management Service

Thomas Jefferson University
Jefferson Medical College
Department of Anesthesiology
Philadelphia, PA

Introduction - TOP

Intravenous patient-controlled analgesia (IV PCA) is a widely accepted standard for management of acute postoperative pain.  PCA devices consist of programmable pumps and activation buttons.  The ordering physician controls the infusion rate, bolus volume, maximum allowable hourly dose, and lockout time.  The patient controls the activation button triggering a bolus opioid dose through an intravenous line.    Lockout time serves as a major component of the inherent safety mechanism of PCA to prevent accidental patient overdose.  Patients will be unable to stack bolus doses of opioid with repeated presses of the activation button.  Additionally, if a patient administers too much analgesia, they will experience sedation thus inhibiting further self-administration.1 This article will discuss the benefits, drawbacks, typical opioids used, and useful adjuncts in pain management via IV PCA.

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