Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
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Patients undergoing head and neck surgery often have significant pain because of the anatomic area involved, the nature of the surgery and trauma associated with the anesthesia and surgery, or the use of packing postoperatively. A patient-controlled analgesia (PCA) infuser is available that allows the patient to direct delivery of their own analgesia. The physician orders the narcotic analgesic dose to be given, the interval between doses, and the total amount of analgesic to be delivered over 4 hours. ⋯ This system allows the patients to initiate intravenous delivery of their narcotic analgesic, and maintain control of pain, using small incremental doses of the analgesic agent. This PCA pump has been used successfully in a number of patients undergoing various general, head and neck, and facial aesthetic procedures. The general concept of the PCA pump, guidelines for use, and contraindications are presented.