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Patient Controlled Analgesia (PCA)

  • Patient controlled analgesia (PCA) is a form of pain relief which is controlled by the patient (your child). A PCA is a machine which allows your child to administer the analgesia (pain relief medicine) when they need it. The most common pain medicine used in the PCA is morphine. Morphine is given through a plastic tube in a vein (also called an intravenous drip or IV).

    This is a safe technique because the machine used to deliver the pain medicine is programmed according to your child's weight. This lowers the risk of your child over-
    medicating or over-dosing on the morphine.

    Your child is monitored and reviewed by the Children's Pain Management Services (CPMS) team every day, to assess if their pain is well controlled and to ensure that there are no side effects. Side effects such as nausea, vomiting and itch may occur in people taking morphine and can be treated.

    Use of PCA

    The PCA has a handset with a button for your child to press when they have pain. Only your child is to press the button. When the button is pressed, the pain medicine (morphine) is delivered through the IV.

    The medicine can take five to 10 minutes to work, so for safety reasons there is a waiting time of five minutes before the button will allow delivery of another dose of pain medicine.

    Why use a PCA?

    The patient is often the best person to judge when and how much pain they have and how much pain medicine they need to make them feel better. The benefit of having a PCA is that the pain medicine is available immediately. If your child does not need pain relief then they will not be given medication unnecessarily.

    By using the PCA, your child should be able to deep breathe, cough and move around in the bed without too much discomfort. Most children aged over seven years can understand how to use a PCA.

    What should I expect?

    As your child recovers, the pain will become less and they will use their PCA less. The CPMS will stop the PCA after discussion with you and your child and will prescribe another pain medicine that can be taken by mouth, e.g. tablets or a syrup. The length of time a PCA is needed depends on your child and the surgery they have had, but is usually about two to five days.

    At home care / care after procedure

    Your child may need to take pain medicine by mouth for the first few days, until they are comfortably moving and sleeping well. If your child needs strong pain medicine at home you will be given information on what pain medicine to give.  The CPMS nurse will contact you by phone to help you manage your child's pain.

    Key points to remember

    • The PCA is for the patient to use only.
    • The PCA is safe.
    • Your child will be closely monitored.
    • Your child will have their pain assessed regularly.
    • The CPMS will see your child every day

    For more information

    If you want more information, please contact:

    • Children's Pain Management Service
      (03) 9345 5945


    Developed by the RCH Dept of Anaesthesia and Pain Management with the Children's Pain Management Service. First published January 2009. Updated August 2015.


This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.