PCA pump

Author: Ivo Křikava, MD, PhD, Matej Koštialik, Soňa Řezníčková

Institution: Faculty of Medicine at Masaryk University in Brno

Medical discipline: Emergency Medicine

Keywords: patient controlled analgesia | post-operative pain managment | opioid

Educational evel: Undergraduate level | Graduate

The therapy of post-operative pain is an important part of every surgical proccedure and with the development of therapeutic possibilities, the new, better and more effeicient ways such as the PCA pump are introduced.  

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This algorithm discusses another necessary topic – the management of intensive postoperative pain. A very accurate clinical example is chosen - mastectomy is one of the operations after which the post-operative pain can become chronic in a relatively high percentage of cases. Well-managed postoperative analgesia reduces the risk of chronic postmastectomy pain. The algorithm highlights the increasingly available and currently not fully utilized method of patient-controlled intravenous analgesia. It describes the use of the pump, the parameters that need to be set, as well as the choice of opioids that can be used for the PCA, including their dosing. At the same time, in one of its steps the algorithm recommends using gabapentinoids. The use of gabapentinoids is one of the current trends in the way of involving co-analgesics suitable for dealing with neuropathic pain in postoperative analgesia. Their utilisation, among other things, significantly reduces the dose of administered opioids and possibly shortens the period of their administration.

publikováno: 21. 5. 2019 | last modified on: 13. 1. 2020