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PCA - Patient Controlled Analgesia

Common agents / Protocols

Fentanyl Hydromorphone
Meperidine Morphine

Fentanyl  top of page icon

(Usual concentration range: 10 - 50mcg/ml). 
Most common: 10 mcg/ml.

Bolus (Loading)  -Optional
25-50 mcg

Intermittent dose (patient activated dose / demand dose):
Range: 10-50 mcg
Usual starting: 10 mcg

Lockout Interval
6 - 8 minutes (Range: 4-10 min)

4 hour limit (opiate naïve)
3 mcg/kg or max of 300 mcg

Continuous (basal)  - rarely used especially during initiation phase.
10 – 50 mcg/hr

Hydromorphone  top of page icon

(Usual concentration: 0.2mg/ml)

Bolus (Loading)
0.1 to 0.5 mg

Intermittent dose (patient activated Dose):
0.05 - 0.5mg Usual: 0.1 - 0.2mg

Lockout Interval
6 - 8 minutes (Range: 3-15 min)

4 hour limit (opiate naïve)
0.06 mg/kg or max of 6 mg

Continuous (basal)–optional
0.1 to 0.5 mg/hr

Meperidine  top of page icon

(Least preferred)
(Usual concentration: 10mg/ml)

Bolus (Loading)
10 - 50 mg. Usual: 25 mg

Intermittent dose (patient activated Dose):
5 - 30mg Usual: 10 mg

Lockout Interval
6 - 8 minutes (Range: 3-15 min)

Continuous (basal) –optional
5 - 20 mg/hr (avoid)

Morphine   top of page icon

(Usual concentration: 1 mg/ml)

Bolus (Loading)
1-5 mg. Usual: 2 mg

Intermittent dose (patient activated Dose):
0.5-3mg Usual: 1 mg

Lockout Interval
6 - 8 minutes (Range: 5-12 min)

4 hour limit (opiate naïve)
0.3 mg/kg or max of 30mg

Continuous (basal)–optional
0.5 – 2 mg/hr
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Reference(s)

National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.
Provides access to the latest drug monographs submitted to the Food and Drug Administration (FDA). Please review the latest applicable package insert for additional information and possible updates.  A local search option of this data can be found here.

Disclaimer

Listed dosages are for - Adult patients ONLY. PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER. GlobalRPH does not directly or indirectly practice medicine or provide medical services and therefore assumes no liability whatsoever of any kind for the information and data accessed through the Service or for any diagnosis or treatment made in reliance thereon.

David F. McAuley, Pharm.D., R.Ph.  GlobalRPh Inc.
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