Patient-Controlled Analgesia for Managing Pain in Adults Receiving Palliative Care: A Scoping Review.

Abstract

Background: Pain remains a significant concern in palliative care settings. Patient-controlled analgesia (PCA) is an opioid delivery system that allows patients to decide when to receive a personally titrated opioid dose. This method of opioid administration effectively and safely manages pain and allows autonomy over one's care.

Objective: To understand the extent of evidence regarding PCA for pain management among adults in palliative care settings.

Methods: Systematic searches of PubMed, CINAHL, Embase, and MEDLINE identified 421 articles published in English between 2009 and 2024. The following data was extracted from eligible articles: source, author, study purpose, location (country and care setting), sample, design and methodology, participant characteristics, and relevant results.

Results: Five studies met inclusion criteria. Findings include information on the PCA devices, rationale for administration, efficacy, and safety, adverse events, and author-identified next steps. Overall, PCA use was found to be safe and effective, sometimes even preferable to other opioid administration regimens.

Conclusion: This review provides insights into optimizing pain management for cancer patients, especially in advanced stages of illness. Findings highlight the minimal literature available regarding PCA use in palliative care settings, particularly the complete absence across noncancer diagnoses.