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Query: UMLS:C0220723 (PCA)
 4,687 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Given the discomfort of thoracic surgical incisions, thoracic surgeons must understand and use contemporary multimodality pain treatments. Acute postthoracotomy pain not only causes psychologic distress to the patient but also has detrimental effects on pulmonary function and postoperative mobility, leading to increased morbidity. By choosing the most appropriate and least traumatic surgical incision, adhering to meticulous surgical techniques, and avoiding intercostal nerve injury or rib fractures, surgeons can minimize postoperative pain. Aggressive perioperative and postoperative pain management is best accomplished with use of an epidural anesthetic and covering breakthrough pain with an IV-PCA. Alternatively, an infusion system for continuous administration of local anesthetics directly in the subpleural plane, posterior to the intercostal incision, also provides excellent pain control. Again, use of an IV-PCA as adjuvant therapy is recommended. With careful planning, severe pain and its negative impact on thoracic surgical patients can be prevented.
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PMID:Management of postthoracotomy pain: acute and chronic. 1700 57

Creative approaches, such as NAD, can be taken to manage pain in patients who would be candidates for PCA therapy if they were physically and cognitively able to manage their own pain. NAD authorizes the patient's primary nurse to administer bolus doses with or without a basal rate via the PCA infusion pump. Doses are administered for breakthrough pain with a basal rate or in scheduled doses to maintain analgesia without a basal rate. It is also used to administer bolus doses before and during painful procedures.
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PMID:Unconventional use of a PCA pump: nurse-activated dosing. 2561 91