Information for patients and carers Patient controlled analgesia for pain relief after surgery Diagnostics and Clinical Services Anaesthetics and Acute Pain Team
This leaflet is for anyone who may benefit from patient controlled analgesia (PCA) after surgery. We hope it will answer any questions you may have. This booklet explains what to expect when you have a PCA for pain relief after your operation. Methods of pain relief will be discussed with your anaesthetist prior to your operation. What is patient controlled analgesia (PCA)? PCA is a method of pain control. The device allows you to press a button and give a pre-set dose of pain relieving medicine whenever you require it. How does the PCA work? The pump will be connected to a vein in your hand or arm. It contains a supply of pain relieving medication. All you have to do is press and release the button on the handset and you will receive just the right amount of pain relieving medicine. The dose is delivered instantly into your veins and will take your body only a few seconds to absorb the medicine. The doctor or nurse will programme the PCA pump. The pump is placed by your bed on a stand with wheels to allow you to get out of bed and move around. Who can use the PCA? As long as you are able to press the delivery button independently on the pump you can use the PCA. Your anaesthetist will decide if the PCA is right for you. No one else should press the button for you. When can you start using the PCA? You will be able to start pressing the button on the PCA when you wake up from your operation. The PCA pump works best if you the pain relief when you need it whatever time of day or night it is. How often should you press the button? Do not let the pain build up. If you start to feel uncomfortable simply press the button as often as you feel necessary. The pump has safety features inbuilt so that it will only give you another dose of pain relief once the set time of 5 minutes has passed. Therefore, if you press the button within the 5 minute lock out period the pump will not administer a dose. The pump has safety features built in so the settings cannot be altered by anyone other than a trained nurse.
Remember you cannot overdose with the PCA. If you are going to move around and think it will hurt then press the button a few minutes before moving. You will not become addicted to the pain relieving medicine as long as it is only used for pain. What if you press the button but the pain does not go away? The nurses will be continuously monitoring your progress with the PCA asking you to describe your pain but you must tell the nurse if you still have pain. The pain score of 0-3 is used to describe and record pain at this hospital. 0 = no pain 1 = mild pain 2 = moderate pain 3 = severe pain As your recovery progresses your needs will alter. Paracetamol will be given regularly whilst you are on the PCA. Even though paracetamol is only a mild analgesia, it works well with the pain relieving medicine. What if you fall asleep and forget to press the button? If you are not in pain then you will not need another dose. If you have been asleep for a long period of time, you may have to press the button frequently until you are comfortable. How long will you need the PCA? The doctors and nurses will discuss you progress with you and decide when to stop the PCA and commence oral analgesia. The pump will be discontinued once you are eating and drinking. What are the advantages of a PCA? The main advantage is that you are in control of your own pain relief. You do not have to wait for the nursing staff to get the analgesia for you or to give you repetitive needle injections. You will be able to move about in bed more easily and sit out of bed, which is beneficial for post-operative recovery. 2
What are the common side effects of the PCA? The pain relieving medicine can sometimes cause side effects. If you suffer from nausea and vomiting then this can be treated with anti-sickness medicine. Some people also complain of itching and this can be treated with anti-allergy medicine. It is very important that if you do suffer any side effects, you report it to the nurse who will ensure that these are treated appropriately. We do not want you to stop pressing the button and be in pain. How do you ask any further questions? You can ask the nursing staff or doctor/midwife. Also it is possible to ask to speak to with the anaesthetist or the pain nurse who might be able to answer any further questions you may have. 3
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Sources of further information www.lancsteachinghospitals.nhs.uk www.nhsdirect.nhs.uk www.patient.co.uk NHS choices Lancashire Teaching Hospitals NHS Foundation Trust is not responsible for the content of external internet sites. Please ask if you would like help in understanding this information. This information can be made available in large print and in other languages. References Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine (2015) Acute Pain Management: Scientific Evidence, second edition Alaris Medical Systems (2004) Understanding Patient Controlled Analgesia, Basingstoke, United Kingdom We re now smoke free. Smoking is not permitted anywhere on any of our premises, either inside or outside the buildings. Our staff can offer support and advice or you can contact the Quit Squad Freephone 0800 328 6297. Department: Anaesthetics and Acute Pain Team Division: Diagnostics and Clinical Support Production date: August 2017 Review date: August 2020