**Patient-Controlled Analgesia (PCA) in Acute Pain: Pharmacological and Clinical Aspects**

Marcos Tadeu Parron Fernandes, Fernanda Bortolanza Hernandes, Thaís Natália de Almeida, Vitor Pinheiro Sobottka, Regina Célia Poli-Frederico and Karen Barros Parron Fernandes

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/67299

#### **Abstract**

Moderate or severe pain are important sources of complications as well as morbidity and mortality in the postoperative period after surgical procedures. Patient‐controlled analge‐ sia (PCA) is an effective strategy for postoperative analgesia, since it may provide suitable analgesic dose just after system activation, with reduced periods of pain and an increase in patients' satisfaction. Although intravenous and epidural routes are the typical approaches used for PCA, regional patient‐controlled analgesia has been shown to be an effective alter‐ native providing a higher standard of analgesia with lower incidence of adverse effects. New devices and routes of PCA administration (transdermal, sublingual, inhalation, and oral routes) have shown to be promising alternatives in clinical studies. Nowadays, there is still no consensus regarding which is the best route or drug used since clinical efficacy/safety depends on the complex comprehension of the drugs pharmacokinetic profile through dif‐ ferent routes of administration. Additionally, pharmacoeconomic studies are needed to evaluate the cost‐effectiveness of these approaches.

**Keywords:** patient‐controlled analgesia, opioids, acute pain, analgesic medication, morphine
