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5.4 Patient control analgesiaPatient control analgesia (PCA) is the standard technique for the management of moderateor severe postoperative pain. The concept of intravenous PCA is described as a techniquethat allows patients to self-administer intravenous opioids as required and dates back to themid-1960s. Nowadays the drugs used in this kind of devices vary according to hospitalfacilities and clinician preferences. Opioids are the first line drugs used in PCA, however inmany hospitals a combination of opioids and NSAIDs for background infusions with a extrashot at patient request are now used. Regular paracetamol and NSAIDs can be usedsimultaneously. Supplementary oxygen should be considered, particularly on the first andsecond postoperative nights.Over the years, further improvements were made to the design of PCA devices. Thesehave resulted in increases in security and data output capacity, introduction of errorreduction programs, and a choice of mains in battery power. In addition, a variety ofdisposable delivery systems are now available. Before PCA can be used safely andeffectively it is mandatory to educate the patients, all medical and nursing staff involvedin its utilization.
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