A patient-controlled analgesia (PCA) pump is a safe way for a child in pain to give themself pain medicine (analgesia) by pressing a button. The medicine goes through an intravenous (I.V.) tube inserted into a vein. Your child may get the pain medicine through a different route, but this is less common.

With a PCA pump, your child can manage their pain when they need to. This may help your child feel less anxious and less worried about their pain. Your child may also be able to use less pain medicine. They may be able to move around more and feel more alert.

Your child’s doctor or nurse will set up the PCA pump to give your child medicine when your child presses the button. Sometimes PCA pumps are also set up to give a small amount of medicine all of the time.

Here's how the pump works:

• A syringe or other container that’s filled with your child’s pain medicine is placed in the PCA pump.
• Your child’s doctor or nurse sets the pump to release the right dose of medicine.
• When your child feels their pain starting, they press a button that they can hold in their hand.
• After your child presses the button, pain medicine is released from the pump.
• The pain medicine flows from the pump into the I.V. tube that goes into your child’s vein.
• Safety features in the pump prevent your child from getting too much medicine.

Most children need pain management when they are in the hospital. PCA pumps are often used to manage pain after surgery. The pump allows your child to give themself pain medicine as they recover from the surgery. PCA pumps may also be used to manage pain from cancer or other illnesses.

Children often express pain differently from adults. The nurse or doctor can use a special scale to help your child describe their pain. The scale may have facial expressions, numbers, or words. Changes in your child’s physical and emotional behavior can also provide clues about their pain level. These things can help the doctor or nurse assess your child's pain and make sure it's being well managed.

The most common pain medicine used in a PCA pump is an opioid, such as morphine.

There are many different pain medicines. What kind your child receives depends on the cause of your child's pain and what their pain level is. Your child's age, weight, and health history are also factors.

You may have concerns that your child will become dependent on these medicines. But they are given in controlled amounts over a set time. Your child's doctor can answer any of your questions or concerns.

The pump has safety settings that help prevent your child from getting too much pain medicine. Your child’s doctor or nurse will set controls on the pump that limit the amount of pain medicine your child gets. Even if your child presses the button, the pump won't give them more medicine if it isn't time for their next dose.

Nurses will check your child's breathing, alertness, oxygen level, and pain often. Your child's medicine dose will also be safe for their weight, age, and medical condition.

Only your child should press the PCA button. Family members or friends should not press the button. This prevents your child from getting too much medicine.

In some cases, if your child cannot push the button to give themself pain medicine, an authorized caregiver may do it for them. This is a person who is given permission by a child’s doctor to press the button on the PCA pump to manage a child’s pain. It’s often the child’s nurse. But it can sometimes be a parent or other caregiver who’s had special training. This may be an option only at certain healthcare facilities.

To become an authorized caregiver, you'd need training from a nurse or another member of your child’s care team. They can teach you how to use the PCA pump safely. You'd learn how to assess your child’s pain level, so you would know when your child needs a dose of medicine. And you'd learn what problems to watch for, such as side effects of the medicine.

Side effects usually go away when a child stops taking the pain medicine. The care team will monitor your child often for side effects. Talk to your child's care team about any side effects your child has and how to manage them.

Side effects of the pain medicine may include:

• Constipation.
• Itching.
• Trouble urinating.
• Nausea and vomiting.

Tell your child's care team right away if your child has:

• Excessive sleepiness.
• Slow breathing.
• Signs of an allergic reaction, such as a rash, swelling, or trouble breathing.