Patient-Controlled Analgesic Infusion Pumps: Features and Functions

Patient-controlled analgesic (PCA) infusion pumps are typically used to give pain relief to postoperative, obstetric, terminally ill, and trauma patients. They allow patients to self-administer boluses of narcotic analgesic intravenously, subcutaneously, or epidurally, while keeping the amount within the prescribed limits. To avoid overmedication, an adjustable lockout interval inhibits delivery of additional boluses until the appropriate time (typically a few minutes to an hour) has elapsed. In addition, most pumps offer various levels of security, including security-code protection for programming functions and locking drug chambers.

PCA infusion pumps are used to administer narcotic analgesics such as morphine, meperidine (e.g., Demerol), hydromorphone (e.g., Dilaudid), and fentanyl, all of which have a peak effect that occurs within minutes and typically within the clinician-determined lockout period. Also, the prescriber may elect to order a loading dose for the patient. A loading dose is a bolus given to provide immediate pain relief at the start of therapy. The loading dose is considered an "extra"...