Skill 52
Patient-Controlled Analgesia
Patient-controlled analgesia (PCA) is an interactive method of pain management that permits patient control over pain through self-administration of analgesics (D’Arcy, 2008; Wells et al., 2008). A patient depresses the button on a PCA device to deliver a regulated dose of analgesic. It is crucial that candidates for PCA be able to understand how, why, and when to self-administer the medication (APS and AAPM, 2009).
PCA has several advantages. It allows more constant serum levels of an opioid and avoids peaks and troughs of a large bolus. Patients receive better pain relief and fewer side effects from opioids because blood levels are maintained at a level of minimum effective analgesia concentration. Increased patient control and independence are other advantages for patients. Because PCA provides medication on demand, the total amount of opioid use can be reduced.
Delegation Considerations
The skill of administration of PCA cannot be delegated to nursing assistive personnel (NAP). The nurse directs the NAP to:
