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Related Concept Videos

Analgesia and Pain Management01:25

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
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Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...

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Updated: Jun 14, 2026

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
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[Patient controlled analgesia in children].

E Fournier-Charrière1, B Tourniaire

  • 1Unité douleur et soins palliatifs de l'adulte et de l'enfant, CHU de Bicêtre, Assistance publique-Hôpitaux de Paris 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France. elisabeth.fournier-charriere@bct.aphp.fr

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|March 30, 2010
PubMed
Summary

Patient Controlled Analgesia (PCA) allows patients 6 years and older to self-manage morphine for pain relief via a programmable pump. This safe and effective method adapts dosage to pain levels, requiring patient and caregiver education.

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Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery
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Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
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Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery
09:38

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Published on: April 14, 2016

Area of Science:

  • Pain Management
  • Pharmacology
  • Pediatric Care

Background:

  • Patient Controlled Analgesia (PCA) is a method for delivering morphine analgesia.
  • It utilizes a programmable pump allowing patients to self-administer doses.
  • Dosage is customized based on pain levels, with dose limits and lockout periods defined.

Purpose of the Study:

  • To describe the utility and implementation of Patient Controlled Analgesia (PCA) in pain management.
  • To highlight the safety and efficacy of PCA for pediatric patients.
  • To emphasize the importance of training for patients, caregivers, and healthcare staff.

Main Methods:

  • PCA involves patient self-administration of programmed morphine boluses.
  • Initial bolus (titration) manages severe pain.
  • Continuous infusion is an option for severe pain, requiring close monitoring of respiratory rate and sedation levels.

Main Results:

  • PCA effectively adapts morphine dosage to individual pain levels.
  • The method demonstrates a high safety profile when used correctly.
  • Unwanted side effects of morphine analgesia require prevention and management.

Conclusions:

  • PCA is a safe and effective analgesia technique for patients aged six and above.
  • Patient and caregiver education is crucial for successful PCA implementation.
  • Adequate training for nursing staff is essential for managing PCA therapy.