Patient-controlled analgesia: optimizing the experience

A patient-controlled analgesia (PCA) program was established on a surgical unit with children age 7 years and older. The primary objectives for the PCA program were safety and efficacy. A retrospective evaluation of the first 30 patients enrolled in the program suggested in the program suggested that it was safe and adequately controlled pain for all but 4 patients. A chart review of these patients indicated that the relation between the number of failed administration attempts, the total hourly analgesic intake, and the pain intensity score was key to optimizing the use of PCA. Recommendations to strengthen the PCA program were implemented based on information gained from these 4 patients with poorly controlled pain.