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Patient Controlled Analgesia (PCA)

Patient Controlled Analgesia (called “PCA”) is a way to give your child pain medicine. It is most often used to treat pain after surgery, but may also be used for other types of pain.

How does PCA work?

A PCA pump is a special machine that allows a child to safely give pain-reducing medicine to himself.

  • When your child has pain, he pushes a button and a small dose of medicine (called a “bolus”) is given by the PCA pump into his IV. You can teach your child to push the button to “make the hurt go away.”
  • A timer allows the medicine to only be given after a certain amount of time has passed from the last bolus.
  • A PCA pump can be set to give a steady amount of medicine (called a “background,” “basal,” or “baseline” infusion), as well as the bolus dose as needed.
  • The doctor’s order for the steady dose is based on your child’s weight and amount of pain. Your child’s doctor increases or decreases the PCA doses based on your child’s level of pain. The PCA helps reduce your child’s pain to a reasonable level, but may not get rid of all of his pain.
  • Why is PCA used?

    A PCA pump can:

  • Provide safe and steady control of pain
  • Decrease some of the side effects that pain medicines can cause, such as upset stomach and sleepiness
  • Give your child more control over his pain and help him become more active
  • Who gets a PCA pump?

    A PCA pump is used for children with pain from:

  • Surgery
  • Cancer or side effects from cancer treatments
  • Burns
  • Sickle Cell Disease
  • Other painful chronic illnesses

Is PCA safe?

PCA is very safe if the button is pushed only when your child needs pain medication. You should NOT push the button for your child when he/she is sleeping or resting comfortably.

The pump will only give your child the amount of medicine your doctor has prescribed. The amount that is prescribed is based on your child’s weight and him pushing the button only when he is in pain. If he pushes the button more often than the timer allows the bolus dose of medicine will not be given again until enough time has passed.

Pain medicines that are used with PCA (narcotics or opioids) may cause side effects such as nausea, vomiting, itching, constipation, or sedation/excessive sleepiness. Your child’s doctors will order medications to manage these side effects. If your child uses PCA by IV for several days the medication dose will be decreased as your child is switched to oral medications for pain.

What can a parent do to help?

  • Tell us about your child’s pain. It is important for us to know your child’s pain level while he is using PCA. Nurses use pain scoring tools during the day and night to track your child’s level of pain. You can help the nursing staff by encouraging your child to answer the nurses’ questions about his pain. It also helps if you or your child can talk to the nurses about the things that increase or decrease his pain.
  • PCA works best if the child pushes the button himself when he is in pain. If your child is not able to push the button, your doctor may write an order that allows you to push the button for him. This works best if you plan to stay in your child’s room so you can watch for signs of increased pain. It is important that you do not push the button when your child is not in pain. It is best if you wait for your child to tell you he is in pain before you push the button for him.
  • Do not push the button if your child is sleeping.
  • If you feel your child’s pain is not well controlled, or if he is too sleepy or troubled with other side effects, talk to your nurse or doctor.


Disclaimer: This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.

Reviewed: 06/2013