Patient-controlled analgesia
Patient-controlled analgesia (PCA) is one way of helping your child minimize
discomfort after surgery that typically causes moderate to severe pain
afterwards. PCA is a portable, computerized syringe-system connected to a
patient's intravenous line that allows self-administration of medication for
pain relief. PCA allows the child to push a hand-held button that attaches to
and activates the machine. The medication used in the PCA machine is usually one
of several narcotics commonly used in adults and children. The PCA machine is
initially programmed by the anesthesia team.
Your child is monitored by his or her nurse, by visits
from physicians from the Department of Anesthesiology, and sometimes with electronic
monitors that measure heart rate or rhythm, breathing rate and/or oxygen “saturation.”
Adjustments can be made in the dose and sometimes the type of narcotic used so
that your child can be made as comfortable as possible. Among the many safety
features designed into PCA machines is a “lockout"
period. The “lockout”
is
programmed by the anesthesiologist to prevent one dose from being given right
after the previous dose. Generally speaking, children six years of age or older
are candidates for PCA.
Children younger than that are less likely to push the button. Although there
are theoretical risks to giving a child narcotics by PCA or any other route, PCA
has been safely used in children for more than 10 years and has become fairly
routine at most children's hospitals.