PCA: prescribing analgesia for home management of severe pain

Home-based patient-controlled analgesia (PCA) provides select patients with the ability to deliver analgesia based on their own perception of need. PCA allows the patient with severe pain (eg, from cancer) to remain in the home when treatment by oral or rectal routes is no longer appropriate. Patient selection criteria include intact cognition and proper supervision from a family member or health professional. The physician remains responsible for determining the appropriate drug, bolus dose, background infusion rate, and lockout interval. Many of the guidelines that govern these parameters are similar to those that underlie traditional oral therapy.