TYK399
Which of the following best describes the use of patient-controlled analgesia (PCA) in children?
a) Any child over the age of 24 months can be taught to use a demand-only PCA
b) Continuous infusions are safer than demand-only PCA
c) Patients must be at least 6 years old before it is safe to administer PCA in any form
d) Neonates may be eligible for demand bolus PCA if a responsible, trained adult administers the bolus
e) IV intermittent boluses are safer than PCA in children under 3 years old
Answer
Answer d. With proper education and cardiorespiratory monitoring, PCA demand boluses (so-called “parent-controlled” or “nurse-controlled” PCA) have been administered to patients as young as infants and neonates. Most children are not able to self-control a PCA until approximately 6 years of age, although there is considerable inter-patient variability in psychomotor development and reasoning. Two of the key safety features of PCA are (1) frequent, small doses are safer than less frequent large doses of respiratory depressants, and (2) patients will self-titrate by pressing the PCA demand less when somnolence ensues (thus avoiding respiratory depression). For these reasons, answers B and E are incorrect.
Notes
- This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.