Anaesthetists Handbook - MEDICAL EDUCATION at University ...

Pain management and postoperative careStep 2Give 0.5mL – 1mL of the diluted morphine solutionWait 3 - 5 minutesReturn to STEP 1--Repeat STEP 2 until a pain score of 0 or 1 has been achieved.If pain score remains 2 or 3 contact medical team / pain team forfurther advice.Patient controlled analgesiaPre-filled Baxter disposable morphine PCA devices are available in1 mg and 2 mg bolus preparations.This guideline was last reviewed in 2007. Essential points are listedbelow.• The anaesthetist should assess and educate the patient.• PCA devices must not be used in areas where staff have notreceived relevant education.• PCA devices must be attached using a dedicatedintravenous line or using a one-way valve.• PCA must be prescribed properly on the drug chart.• Supplemental oxygen must be prescribed for at least 24hours unless contraindicated.• Intramuscular opioids must not be co-prescribed.• An appropriate rescue antiemetic must be prescribed.• Always ensure that if sudden severe pain or an unexpectedincrease in pain scores occurs, that appropriate medicalexamination is carried out to exclude surgical or medicalcomplications.Anaesthetists Handbook January 2010 107