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PCA – Patient Controlled Analgesia

Fentanyl 

(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 

(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 

(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  

(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.

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