Overview
What the Pump Does
Patient controlled analgesia (PCA) delivers a short acting opioid—such as morphine, fentanyl, or hydromorphone—through a programmable infusion pump.
Patient-controlled analgesia (PCA) delivers a short-acting opioid—such as morphine, fentanyl, or hydromorphone—through a programmable infusion pump. When the patient presses the button, the pump checks whether the lockout interval has elapsed. If it has, the pump delivers the prescribed bolus; if it has not, the request is recorded or ignored without another dose being released. This design allows analgesia to match fluctuating acute pain, particularly after surgery or trauma. The lockout interval and any programmed hourly limit reduce cumulative dosing, but they do not remove the risk of opioid-induced sedation or respiratory depression. A basal infusion is not routine; it should be absent unless specifically ordered because continuous opioid delivery can add to total exposure even when the patient is not requesting analgesia. Adult candidates may include patients with postoperative pain, trauma-related pain, or another acute painful condition requiring parenteral opioid therapy. The patient must be awake enough to understand the purpose of the pump, press the button correctly, and report symptoms. PCA is therefore a treatment requiring both an appropriate opioid order and a reliable patient–pump safety relationship. Unmanaged...