HF 6167

When You Have Both an IV PCA and PCEA

This handout explains the use of two types of patient-controlled pain medicine: IV patient controlled analgesia (PCA) and patient controlled epidural analgesia (PCEA). PCA therapy is based on the beliefs:

  • You (the patient) are the best judge of how much pain you are feeling.

  • The amount of pain medicine needed can vary from patient to patient.


Timing: Often every 10-20minutes. It depends on the doctor’s order.
This allows you to give yourself a dose of opioid pain medicine through your IV. Use this button for pain that is deep in your incision or pain in places the epidural is not working. For extra pain relief it helps if you push it 5 minutes before you get up or move in bed.

The PCA button lights up green when you can get a dose of medicine. If the light is not green, it is too soon to get another dose.


The medicine is quick to work but it does not last very long. It can also:

  • Cause you to be sleepy or nauseous.

  • Slow down your bowels. Take a stool softener or laxative with it.

  • Slow your breathing.

  • May not work as well over time.

  • Lead to long-term dependency.


Timing: Can be pushed every 30 minutes. It depends on the doctor’s order.

When you have a PCEA, a tiny tube is placed in the space outside the spinal cord. Numbing medicine is given through the tube. Medicine is often given nonstop while the epidural is on, but you can also push the PCEA button that gives you an extra dose of medicine. It works best for sharp pain in or around your incision. It is less helpful for deep or widespread pain. For extra pain relief it helps to push the PCEA button 10 minutes before you plan to get up or move around in bed.

The PCEA button has a green flashing light that lets you know when you can get a dose of medicine. If the light is not flashing, it is too soon to get a dose.


  • May make your legs numb or weak.

  • May cause low blood pressure.

  • May cause itching. We can give you medicine to help.

For Your Safety

For a short time after you get a dose from the PCA or PCEA, the pump will not give you any more medicine, even if you press the button again.

Only you, the patient, should press the button to get pain medicine. Family members, friends or visitors should never press the button.