Patient Controlled Analgesia (PCA)

This leaflet explains what a patient-controlled analgesia (PCA) device is, how to use the device and some of the common side effects of using the device.

Why is it important to manage pain effectively in the post-operative period?

Pain is common and expected after surgery. However, uncontrolled pain can stop you from breathing deeply, and stop you from coughing and moving around.

This can lead to complications such as chest infections. These complications can cause your recovery to take longer. It is important that you are given the right amount of pain relief after your surgery to make sure you are comfortable.

What is a PCA?

A PCA device is a machine that is connected to you through your cannula (a small plastic tube into your vein). The machine contains a strong pain killer (most commonly drugs such as morphine, fentanyl or oxycodone).

The device also has a hand held button on it to press to release a small dose of the pain relief medication through the cannula directly into your vein.

This device is normally attached to a drip stand (a pole with wheels) so that you can move around with it. The device stays in place until your pain has lessened.

Who receives a PCA device?

Most often it is patients who have undergone colorectal (bowel) surgery that will receive a PCA device. Other larger operations may also use a PCA.

You will be told before your surgery whether or not you are likely to wake up with a PCA device.

How do I use a PCA?

Whenever you feel pain, press the button on the hand held device. The machine will then release a small, measured dose of the pain relief medication directly into your vein.

The medication should start to have effect within a few minutes to relieve your pain. It is a good idea to also press the button before any movement or procedure to help make things more comfortable.

How often will the PCA be checked?

The nursing staff will check on yourself and the device every 15 to 60 minutes for at least the first 6 hours after being given a PCA device. Once you are more comfortable with how the device works they will check on you every 2 to 4 hours.

Can you take too much medication?

It is very unlikely that you will receive too much pain relief medication. The machine is set carefully to make sure you can not give yourself too much medication and when the nurses check on you they will adjust the machine or doses if necessary.

This means that once you have pressed the button and the machine has delivered a dose of medication, it will not give any further doses until a set period of time has passed. You may press the button for more medication in this period but nothing will be given.

This is to make sure that the medication that has been delivered has time to take effect and prevent any risk of overdose. Sometimes the medication can take a few minutes to work.

What are the benefits of using a PCA device?

• You are in control of your own pain relief
• You do not have to wait for staff to be present to give you medication
• The medication works quickly

What are the side effects of the medications used within the PCA?

• Nausea
• Drowsiness
• Light-headedness
• Constipation
• Itchy skin
• Vivid dreams

If you are affected by any of these side effects, please tell the nursing staff looking after you as they can often manage these symptoms with other medications. You can be switched to another form of pain relief if the side effects are having a negative effect on your recovery.

What if I still have pain when using the PCA device?

If you are still in pain when using your PCA device, please tell the nursing team caring for you. They might be able to give additional medications as well as the pain relief contained within your PCA device.

The nursing team will also regularly monitor your pain throughout your admission and will check how well the device is working to control your pain.

How long will the PCA device be in place?

This will depend on the surgery you have had and how quickly you recover from the operation. However, usually the PCA device is in place for no longer than 24 to 48 hours after your operation.

What happens when the PCA device is stopped?

Once your pain can be managed with oral medications your PCA device will be stopped. You will be monitored closely to ensure your oral medications are working to control your pain.

When your doctor is happy that you are well enough to return home, they will discuss any need for pain relief with you for your discharge home.

Further Information

If you would like to read more about the different forms of pain relief used after surgery and PCA devices, please use the link below to visit the Royal College of Anaesthetists web page on pain relief.

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. The office is based on the ground floor at the University Hospital of North Tees if you wish to discuss concerns in person. If you would like to contact or request a copy of our PET leaflet, please contact:

Telephone: 01642 624719

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Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:

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