Patient-Controlled Analgesia in ICU: A Scoping Review

TL;DR

This review explores how PCA is used in ICU settings, finding it effective but needing more standardized research.

Contribution

The study maps current evidence and identifies gaps in PCA use for ICU patients, highlighting the need for standardized research.

Findings

PCA provides pain control comparable to traditional methods in post-cardiac surgery ICU patients.

PCA is feasible and safe with low respiratory risks due to intensive monitoring.

Evidence for non-surgical ICU patients is limited, and methodological variability hinders comparisons.

Abstract

Background/Objectives: Patient-Controlled Analgesia (PCA) is a well-established strategy for managing postoperative pain, but its use in the Intensive Care Unit (ICU) remains poorly defined, poorly standardized, and fragmented. The aim of this scoping review is to map the extent, nature, and characteristics of the available evidence on the use of PCA in ICU patients, identifying key areas of uncertainty and knowledge gaps that require further study. Methods: Scoping review reported according to the PRISMA-ScR guidelines. Results: 12 relevant studies were identified. Available evidence suggests that PCA can provide pain control comparable to traditional techniques in post-cardiac surgery patients in the ICU, while data on its use in non-surgical patients are limited. The studies reported good feasibility and a generally favorable safety profile, with a low incidence of significant respiratory events thanks to intensive monitoring. Methodological variability prevents direct comparisons between studies. Conclusions: PCA supports personalized pain management based on patient-specific clinical conditions and response. However, more standardized studies are needed to define its role.

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