Patient-Controlled Analgesia: Different Results in Trauma Pain and Abdominal Pain

Patient-controlled analgesia (PCA) has been shown to be more effective than physician-ordered analgesia for nontraumatic abdominal pain (NEJM JW Emerg Med Jun 2012 and Acad Emerg Med 2012; 19:370). In two separate multicenter randomized trials, investigators in the U.K. compared PCA and usual care (nurse-titrated analgesia) in 200 emergency department patients with nontraumatic abdominal pain and 200 with pain from traumatic injury. Patients rated their pain hourly for 12 hours.

In the nontraumatic abdominal pain study, PCA patients spent less time in moderate or severe pain, had lower aggregate pain scores, received more morphine, and were more satisfied with their care. In the traumatic injury pain study, there were no significant differen…