- Reference Number: HEY379/2025
- Departments: Pain Medicine
- Last Updated: 30 April 2025
Introduction
Your doctors will usually decide if you need an Intravenous patient-controlled analgesia (IV-PCA), to manage your pain after your operation. This leaflet has been produced to give you general information about your IV-PCA.
Most of your questions should have been answered by this leaflet. It is not intended to replace the discussion between you, and your doctor, but may act as a starting point for discussion. After reading this leaflet, if you have any concerns or require further explanation or advice on your pain relief options, please discuss with a member of the healthcare team.
What is Intravenous Patient Controlled Analgesia (IV-PCA)?
This is a method of pain relief known as Intravenous Patient Controlled Analgesia (IV-PCA) that is used mainly after major surgery.
Patient Controlled Analgesia (PCA) means that you actually have control over your own pain relief. You will have a pump connected to your drip (usually in your arm or neck) which contains a strong pain reliever, often morphine (although in some cases different pain relief medication may be used). You will have a button to press if you have pain, this will deliver a small dose of the pain relief medication into your drip. You do not need to tell the nurse as the pump will record your presses.
While you are on an IV-PCA, you will be reviewed by a member of the Acute Pain Team the day after your surgery (unless it is the weekend). This is to ensure you are getting the best results from your pain relief. The IV-PCA will be used for 2 to 3 days or until you have an alternative method of pain relief.
How do I use the pump?
If you are in pain, you have to press the button on the handset to be given a dose of the pain-relieving medication (when the green light is on the button). The green light will flash as you receive the dose. The pump will then lock you out for 5 minutes, meaning even if you try press the button, you will not receive any medication. This is so you do not have too much of the pain relief medication and is safe. If your pain is still not controlled or having difficulty pressing the button, then please speak to your nurse.
How quickly will the pain relief medication work?
It will not work immediately. The pain relief medication needs to get to the brain and spinal cord, and it may take 5 minutes or longer for the pain relief medication to work fully. If you are about to do something that you know will be uncomfortable, such as deep breathing exercises or moving, press the button about 5 minutes before doing it.
If you are pressing the button quite frequently and are still uncomfortable, tell your nurse, who will first check that the drip is running properly. As long as you are not sleepy your nurse can either give you other prescribed pain relief medication or consult the Acute Pain team.
Can there be any complications or risks?
IV-PCA is probably one of the safest ways of giving strong pain-relieving medication. The pump only delivers a small dose of the pain-relieving medication. If this makes you sleepy, you will not press the button again, allowing the pain relief medication to get out of your system. Some people are more sensitive to pain-relieving medication and can feel drowsy. Your nurse will notice this and seek advice if necessary. As the amount of pain-relieving medication needed varies greatly between patients, the dose may need to be altered.
When pain relief medication like morphine is used to treat acute pain, such as pain after operations or accidents, the risk of addiction is low. It is very important not to let the concern of addiction stop you from using enough of the pain relief medication. You need to be comfortable to move, take deep breaths and to cough.
Will I feel sick?
Feeling sick after an operation is not uncommon – pain relief medication like morphine is only one possible cause. Whatever the cause, you will be prescribed other pain relief medication called anti-emetics which can help relieve the nausea or vomiting. If one of the pain relief medications does not work, you can always try a different one.
How long will I use IV-PCA?
Generally, the IV-PCA will be used between 2 to 3 days, although if you are not able to eat or drink it may be longer.
During your recovery you should find your pain levels reduce and that you do not need to use the IV-PCA as much. Once you can drink fluids, your doctor will prescribe some regular pain relief medication, often tablets. Once your pain can be controlled with these more simple methods, the IV-PCA will be stopped.
Should you require further advice on the issues contained in this leaflet, please speak to your medical and nursing team, who can refer to the acute pain service if required.
