Patient-Controlled Epidural Analgesia (PCEA)

Overview

This system allows a patient to administer anesthetic medication as needed to control pain. It is frequently used to ease the pain of childbirth. PCEA requires the insertion of a catheter, typically in the epidural space.

Preparation

The patient sits or lies on her side to expose the back. The skin is cleaned and sterilized. A small needle injects a local anesthetic, creating a numb pathway down to the spine.

Inserting the Catheter

A larger needle is carefully inserted through the numb tissue and guided to the spinal column. The needle is not pushed through the dura, the sac that surrounds the spinal cord, but stops just outside this sac. A small catheter is fed through the needle, and the needle is removed.

Regulating the Anesthetic

The other end of the catheter is attached to a pump that can be controlled by the patient. Whenever the patient feels pain, the patient can push a button to deliver more anesthetic. The pump will be programmed to only allow a certain number of doses per hour to greatly reduce the chances of an overdose.

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