Pain Doctor Little Rock requires a combination of drug therapy and non-drug therapy, but the use of analgesics is the mainstay. The WHO method of cancer pain treatment is an analgesic method that comprehensively uses analgesic aids, side effect countermeasures, psychosocial support, etc. in addition to the use of non-opioid analgesics and opioids, and is resistant to drugs. For pain, non-drug analgesics such as nerve block should be considered in parallel with the application of the three-step pain relief ladder.PCA is an abbreviation for Patient Controlled Analgesia, which means “self-regulated analgesia.” Usually, morphine-based injections are administered intravenously or subcutaneously using a machine called a PCA pump. The biggest feature of the PCA pump is that the PCA pump has his button, which allows the patient to press the button and participate in pain control in case of pain. At our hospital, we prescribed PCA to patients who were involved in a palliative care team of about 80 people last year.There are three modes of PCA machine settings. The first is a continuous dose, which is a mechanism in which a fixed amount of drug solution is automatically administered without pressing a button. The second is a mechanism in which a preset amount of drug solution is administered each time the button is pressed. The third is the refractory period (lockout), in which the drug is not administered no matter how many times the button is pressed until a certain period of time has passed after the drug was administered by pressing the button. It’s a mechanism. These three modes are set individually according to the patient’s pain type and general medical condition.
Other key benefits of PCA include:
1. You can administer painkillers immediately for pain (don’t hesitate to ask a nurse)
2. Pain control is possible faster than oral administration by intravenous or subcutaneous administration.
3. If you have frequent pain, you can use pain medicine in detail each time.
4. Prophylactic medication can be given when pain can be predicted in advance (wound treatment, body posture or specific movements, rehabilitation or pre-examination movement, etc.).
5. Can be used when regular oral or suppositories cannot be used during vomiting or diarrhea.
6. Fine dose adjustment may be possible when oral dose adjustment is difficult, such as when the appropriate range of drug requirements is narrow.
7. For a short period of time, the required amount of pain medicine can be measured quickly.
The main points to note about PCA are as follows.
1. If you have cognitive decline, confusion, or strong anxiety, you are at risk of overdose by pressing a button for reasons other than pain.
2. The number of IV tubes increases, making it difficult to move.
3. At the time of discharge, the PCA will be changed to the usual oral or patch analgesic method, but if that is not possible for some reason, the system for continuing PCA at the outpatient department or at home is not yet fully established . PCA can be continued.
PCA is not yet widely used as an analgesic method for palliative care in Japan. In the United States, where I trained in palliative care, PCA is widely used as a common pain reliever when oral, patch, suppository, etc. are difficult to relieve. If analgesia is poor even with intravenous or subcutaneous PCA, morphine-based drugs and local anesthetics can be managed as epidural PCA at the same time.
