Patient-controlled analgesia for infants and children


  • D. Simić University Children Hospital, Belgrade, Serbia
  • I. Budić Clinical Centre Nis, Serbia
  • I. Simić University Children Hospital, Belgrade, Serbia
  • Z. Stanković University Children Hospital, Belgrade, Serbia
  • M. Milenović Medical faculty, University of Belgrade, Serbia
  • M. Stević University Children Hospital, Belgrade, Serbia


patients cotrolled analgesia, PCA, children analgesia, pain management


Patients cotrolled analgesia (PCA) pump is an analgesic system where the patient is being deliverd a continuous minimal basal infusion of analgesics (mostly opioids), and the patient can delivere himself an additional bolus of drug by pushing the button. PCA pump is used for moderate to severe pain which requires multiple doses of IV analgesia. It is said that as soon as a child can play computer games, he can use and understand the PCA system. PCA allows the patient to have better analgesia with less dose of drugs than when it is used around the clock. During the first 24 hours, low doses of continuous infusions (background) improve the quality of sleep in pediatric patients without increasing side effects PCA is most commonly used on children for analgesia after major surgery, trauma with preserved sensorium, burns, sickle cell disease, malignancy or painful consequences of chemo-therapy (pain due to mucositis) and in some cases of chronic pain. Patients are generally started on a morphine infusion. Opioid switching in children is strongly recommended in the presence of inadequate analgesic effect and intolerable side effects. The usual, safe dose of morphine that provides adequate postoperative analgesia is in pediatric patients 10–30 mcg/kg/h. In pediatric population for PCA, fentanyl continuous infusions (1 mcg/kg per hour) plus fentanyl boluses (1 mcg/kg) can be safely used. The advantage of PCA is that it eliminates the high peaks and low troughs by allowing the patient to press the demand bolus button when they begin to feel pain. Most of them are very satisfied that they have participated in their own pain management. PCA allows safe analgesia in pediatric patients and lowers frequency of side effects. Patient indicates that their pain level is at a level acceptable to them and that they are happy with this method of analgesia.


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How to Cite

Simić D, Budić I, Simić I, Stanković Z, Milenović M, Stević M. Patient-controlled analgesia for infants and children. PMJUA [Internet]. 2017 Sep. 1 [cited 2023 Feb. 2];2(3):19-23. Available from:

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