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Patient Controlled Analgesia (PCA)

PCA is a method of giving the patient control over their own pain management post operatively. Research suggests that analgesia given in small frequent amounts is more effective than larger doses spread over greater periods of time e.g. every 4-6 hours.

A PCA machine is a computer driven pump that holds a syringe loaded with pain relieving medication. It is attached to an IV pole and the line from the syringe is connected into your already existing IV line. Also attached to the PCA machine is a lead with a control on the end. On the control is a button that you push once when you feel pain. You know the machine has registered the push when you hear a beep.

The medication will be released into your IV line, so the effect will be quite quick but it may take up to 5 minutes for the full effect to take place. The machine will only allow a dose to be administered every 5 minutes, the button on the hand control will light up when it is ready to administer again (not all machines have this feature). If you push the button again, before the 5 minutes, nothing will happen. The idea is to continue to push the button every 5 minutes until the your pain is under control. It is important to note that you should not allow your pain to become unbearable before pressing the button as it will be harder to bring the pain back under control and more difficult for you to remain comfortable.

If pain is not relieved using this method then you should contact the nurse.

The PCA can also be used prior to doing something that you know will cause pain or discomfort, like physiotherapy or walking. By doing this you are able to perform the activity more comfortably and effectively.

The acute pain team, which includes an anaesthetist, should visit each day. They will look at the machine and be able to determine how often the button has been pushed and how much analgesia has been administered over the previous 24 hours. Once you have commenced on oral analgesia they will determine when the PCA is removed.

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