Patient-controlled analgesia in palliative care - Concepts and practical aspects

Abstract

Patient-Controlled Analgesia (PCA) involving the use of on-demand subcutaneous or intravenous opioids offers patients greater autonomy in managing pain. In palliative situations, this method allows a continuous background infusion rate of opioids and allows a patient to self-administer a pre-set bolus dose of opioids. Indications for PCA are moderate to severe pain that is not relieved by 3rd level analgesics administered in oral ore transdermal route or by intermittent injections. PCA prescription, programming, initiation, and safety monitoring require the vigilance of a trained interdisciplinary team. PCA is safe and effective on hospice inpatients and outpatients and encourage their return or their stay at home.