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Patient-controlled analgesia (PCA) is one way of helping your child minimize discomfort that typically causes moderate to severe pain after surgery. PCA is a portable, computerized syringe-system connected to a patient's intravenous line that allows self-administration of medication for pain relief. PCA allows the child to push a hand-held button that attaches to and activates the machine. The medication used in the PCA machine is usually one of several narcotics commonly used in adults and children. The PCA machine is initially programmed by the anesthesiology team.
Your child is monitored by their nurse, by visits from physicians from the Department of Anesthesia, and sometimes with electronic monitors that measure heart rate or rhythm, breathing rate and/or oxygen "saturation." Adjustments can be made in the dose and sometimes the type of narcotic used so that your child can be made as comfortable as possible.
Among the many safety features designed into PCA machines is a "lockout" period. The "lockout" is programmed by the anesthesiologist to prevent one dose from being given right after the previous dose. Generally speaking, children 6 years of age or older are candidates for PCA.
Children younger than 6 are less likely to push the button. Although there are theoretical risks to giving a child narcotics by PCA or any other route, PCA has been safely used in children for more than 10 years and has become fairly routine at most children's hospitals.