Patient controlled analgesia
An overview of its use in pain management
Analgesia is the patient’s ability not to detect pain while conscious. Inadequate pain control is a common complaint among inpatients and such pain increases morbidity and mortality. In particular, pain can inhibit patients’ ability to breathe deeply, cough, and move. This increases the risk of chest infection, deep vein thrombosis, and pulmonary embolism. Pain control, therefore, is of paramount importance. Successful analgesia should treat pain effectively and minimise side effects without the risk of overdose.
Patient controlled analgesia can be used in many clinical situations, including after operations, oncology, sickle cell crises,1 and burns management. It is essentially maintenance once the patient’s pain is initially controlled. It allows patients to administer the appropriate doses of analgesia when required, which has been shown to reduce associated anxiety.2
Analgesia should be administered in an escalating fashion appropriate to the patient’s intensity of pain. Using this stepwise approach the administration of unnecessary analgesia