Patient-controlled analgesia in adolescents

Patient-controlled analgesia (PCA) is a method of administering narcotics in which the patient activates a machine to administer a small bolus of narcotic. In the first year of PCA use in our hospital, 26 patients used PCA. We suggest a dose volume of 0.015 mg/kg/dose and a 4-hour limit of 0.25 mg/kg/4 hr, with a lock-out of 10 minutes. Patients used approximately equivalent amounts to standard parenteral narcotics, but there was a wide interpatient variability in the amount of narcotic used. No clinical respiratory depression was noted, and patients did not titrate themselves to complete analgesia. PCA is an effective means of pain control in adolescent patients.