Abstract
Good pain management after surgery is important to reduce complications associated with pulmonary and cardiac function and to promote earlier ambulation and faster recovery. In Japan, Patient-Controlled Analgesia (PCA) has been a widely accepted standard for acute pain management over the past decade. Intravenous PCA (IVPCA) is a popular choice because of its practicality, and it can also be used by patients who receive anticoagulant therapy during the perioperative period. However, the US Food and Drug Administration has reported adverse events involving PCA. These events were due to overdose of opioids due to misprescription, pump misprogramming, or device malfunction, all of which should be preventable by careful postoperative monitoring. To make it safer for patients to use PCA pumps, anesthesiologists, surgeons, nurses and medical engineers should cooperate and to enhance the safety of IVPCA. This article will review the basic concept of IVPCA and discuss multidisciplinary postoperative pain management and recent advances in acute postoperative pain management.
