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Pediatric Drugs
Published in: Pediatric Drugs 4/2001

01-04-2001 | Review Article

Patient-Controlled Analgesia

An Appropriate Method of Pain Control in Children

Authors: Andrew J. McDonald, Dr Michael G. Cooper

Published in: Pediatric Drugs | Issue 4/2001

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Abstract

Patient-controlled analgesia (PCA) is an analgesic technique originally used in adults but now with an established role in paediatric practice. It is well tolerated in children as young as 5 years and has uses in postoperative pain as well as burns, oncology and palliative care.
The use of background infusions is more frequent in children and improves efficacy; however, it may increase the occurrence of adverse effects such as nausea and respiratory depression. Monitoring involves measurement of respiratory rate, level of sedation and oxygen saturation. Efficacy is assessed by self-reporting, visual analogue scales, faces pain scales and usage patterns. This is optimally performed both at rest and on movement.
The selection of opioid used in PCA is perhaps less critical than the appropriate selection of parameters such as bolus dose, lockout and background infusion rate. Moreover, opioid choice may be based on adverse effect profile rather than efficacy.
The concept of PCA continues to be developed in children, with patient-controlled epidural analgesia, subcutaneous PCA and intranasal PCA being recent extensions of the method. There may also be a role for patient-controlled sedation. PCA, when used with adequate monitoring, is a well tolerated technique with high patient and staff acceptance. It can now be regarded as a standard for the delivery of postoperative analgesia in children aged >5 years.
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Metadata
Title
Patient-Controlled Analgesia
An Appropriate Method of Pain Control in Children
Authors
Andrew J. McDonald
Dr Michael G. Cooper
Publication date
01-04-2001
Publisher
Springer International Publishing
Published in
Pediatric Drugs / Issue 4/2001
Print ISSN: 1174-5878
Electronic ISSN: 1179-2019
DOI
https://doi.org/10.2165/00128072-200103040-00004

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