Patient-Controlled Analgesia in ICU: A Scoping Review

Area of Science:

• Critical Care Medicine
• Pain Management
• Evidence Synthesis

Background:

• Patient-Controlled Analgesia (PCA) is established for postoperative pain but lacks clear definition and standardization in Intensive Care Units (ICUs).
• Existing PCA use in ICUs is fragmented, necessitating a comprehensive overview of current evidence.

Purpose of the Study:

• To conduct a scoping review mapping the evidence on PCA use in ICU patients.
• To identify uncertainties and knowledge gaps regarding PCA in the ICU setting.

Main Methods:

• Scoping review methodology adhering to PRISMA-ScR guidelines.
• Systematic identification and synthesis of relevant studies on PCA in ICUs.

Main Results:

• 12 studies were included, suggesting PCA provides comparable pain control to traditional methods in post-cardiac surgery ICU patients.
• Evidence for PCA in non-surgical ICU patients is limited.
• PCA demonstrated good feasibility and a favorable safety profile with low respiratory events due to intensive monitoring.
• Significant methodological variability across studies hinders direct comparisons.

Conclusions:

• PCA facilitates personalized pain management tailored to individual patient needs and responses in critical care.
• Further standardized research is essential to establish definitive guidelines for PCA implementation in ICUs.