Can patient controlled analgesia be used by children?
Yes. PCA allows children to administer small intermittent doses of analgesics when needed. PCA is prompt, economical, adjusts for variability in children’s analgesic needs, and removes the barrier of assessment judgment and bias. Research indicates children use less opioids when delivered with a PCA device than when intermittent doses are administered by nurses for their pain. PCA has been used in children for more than 30 years and has a high degree of safety. Most children more than 6 years of age can appropriately use PCA. Screen children for their ability to activate the device, provide self-report of pain, understand the need to activate the device before their pain is severe, and report poorly controlled pain despite a PCA. Family members should also be screened to ensure they do not activate the device when the child is asleep, since this overrides the inherent safety of PCA. Continuous infusions or background infusions are not recommended with a PCA for opioid naïve children, although there is some debate among pediatric health care professionals who routinely use PCA to treat children’s pain, particularly those who use it with children less than 6 years of age. Due to the risk of excessive sedation and respiratory depression, monitoring is recommended.
