title: Recent developments in patient-controlled analgesia.
abstract: Patient-controlled analgesia (PCA) has become the gold standard for acute pain management since it was first introduced 20 years ago, and its merits have been discussed in quite a large number of publications. This review summarizes the more recent developments, such as new application devices and strategies, including intranasal, spinal, and regional PCA; patient-controlled sedation; experience with children and elderly people; and some data from chronic pain situations. Analyzing PCA literature from 2001 onwards confirms the author's long belief that the PCA principle ("WYNIWYG": what you need is what you get) was the most important aspect of a patient-controlled strategy, more or less independent of the type of drug or machine. Discovering this principle has changed the understanding of pain and suffering.
authors.affiliation: Department of Anesthesiology, University of Cologne, Cologne, Germany.
authors.forename: Klaus A
authors.initials: KA
authors.lastname: Lehmann
mesh_terms: D016058:Analgesia, Patient-Controlled / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation / Q000639:trends*; D003362:Cost-Benefit Analysis; D006801:Humans; D009369:Neoplasms / Q000150:complications; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome