Child health

Patient information for Translation

Children’s Pain Control in Hospital

Nurse Controlled Analgesia (NCA)

Introduction

This leaflet describes a method of providing pain relief called ‘Nurse controlled analgesia’ or ‘NCA’. You have been given this leaflet as it is likely that your child will have or is having this form of pain relief during their hospital stay. It is used when there is severe pain due to surgical or medical causes.

Before starting nurse controlled analgesia (NCA) a pain nurse or anaesthetic doctor (anaesthetist) will come and see you and your child to explain this method of pain relief. They will ask questions about your child’s health and discuss suitable pain relief options. They will answer any questions you may have. This is to ensure that you understand what medicines your child will be given.

The Pain Management Team

Anaesthetists, specialist nurses and pharmacists are working together to prevent, assess and treat your child’s pain. The pain nurse or anaesthetist will prescribe, start, review and make changes to the NCA.

Nurse Controlled Analgesia

Nurse controlled analgesia (NCA) is a safe way of giving strong pain medicine, usually morphine. Alternatives are fentanyl and oxycodone; occasionally ketamine is added. The pain medicine is given by a pump into your child’s vein via a small plastic tube (cannula). A small amount of medicine is given continuously and if your child appears to be in pain, the nurse looking after them can give an extra dose, or ‘bolus’.

NCA is offered to young children, or older children who are unable to operate a PCA (Patient Controlled Analgesia).

The amount of pain medicine in the NCA is calculated according to your child’s weight. The pump is programmed to provide a safe limit of the pain medicine that can be given. A safety lock-out period ensures that doses can’t be given too often. This reduces the risk of your child experiencing side effects.

It is important that you let the nurses know if you think your child’s behaviour suggests they are in pain. The nurses will assess your child’s pain using an established pain assessment tool. If your child is in pain, the nurse will push the NCA button giving extra pain medicine; the effect will be assessed.

Only qualified nurses and doctors are allowed to push the button on the NCA pump. This is to ensure that your child safely receives the correct amount of pain medicine. Do not push the button as you may endanger your child’s life.

The nurses on the ward are trained to use the NCA pump and assess your child’s pain relief and side effects. Your child will also be reviewed each day, by a pain nurse or an anaesthetist. The pain nurses are usually available Monday-Friday 9am-5pm and at all other times an anaesthetist will be contacted for advice and review if required. They will assess your child’s pain relief and make adjustments as necessary.

Your child will also be given other pain medicines in addition to NCA, usually these include paracetamol and ibuprofen. These will normally be continued once NCA has been stopped. Some children only need NCA for a day or two, whereas others may need it for longer. The length of time a child needs NCA is assessed on an individual basis.

Some children may experience side effects associated with the pain medicine. These can include nausea and vomiting, itching, sleepiness, dizziness, reduced breathing rate, difficulty in passing urine and constipation. Your child will be monitored for possible side effects. If you notice any of these, please inform the nurse looking after your child. Side effects are managed with routinely prescribed medication, but sometimes it may be necessary to change the setting or stop the NCA. Any changes will be discussed with you.

Pain Relief After Stopping NCA

As the pain improves the amount of pain medicine given via NCA will gradually be reduced and stopped. Strong oral pain medicine will be prescribed and given if needed along with paracetamol and ibuprofen.

Medication to Take Home

Paracetamol and ibuprofen may be continued at home. Initially these are given regularly throughout the day, but as your child’s pain improves, the frequency of these can be reduced and then stopped. Paracetamol and ibuprofen can be given together (follow instructions on the medicine boxes for doses).

Some children may need additional stronger pain medicines. The pain team will assess and advise as required.

Large print and other languages
This information can be made available in alternative formats, such as easy read or large print, and may be available in alternative languages, upon request. For more information, speak to your clinical team.
 

এই তথ্যগুলো সহজে পড়া যায় অথবা বৃহৎ প্রিন্টের মত বিকল্প ফরম্যাটে পাওয়া যাবে, এবং অনুরোধে অন্য ভাষায়ও পাওয়া যেতে পারে। আরো তথ্যের জন্য আপনার ক্লিনিক্যাল টিমের সাথে কথা বলুন।

Na żądanie te informacje mogą zostać udostępnione w innych formatach, takich jak zapis większą czcionką lub łatwą do czytania, a także w innych językach. Aby uzyskać więcej informacji, porozmawiaj ze swoim zespołem specjalistów.

Macluumaadkaan waxaa loo heli karaa qaab kale, sida ugu akhrinta ugu fudud, ama far waa weyn, waxana laga yabaa in lagu heli luuqaado Kale, haddii la codsado. Wixii macluumaad dheeraad ah, kala hadal kooxda xarunta caafimaadka.

Bu bilgi, kolay okunurluk veya büyük baskılar gibi alternatif biçimlerde sunulabilir, ve talep üzerine Alternatif Dillerde sunulabilir. Daha fazla bilgi için klinik ekibinizle irtibata geçin.

یہ معلومات متبادل فارمیٹس میں دستیاب کی جا سکتی ہیں، جیسا کہ پڑھنے میں آسان یا بڑا پرنٹ  اور درخواست پر متبادل زبانوں میں بھی دستیاب ہو سکتی ہیں۔ مزید معلومات کے لیے، اپنی کلینکل ٹیم سے بات کریں'۔

Patient Advice and Liaison Service (PALS)

Please contact us if you need general information or advice about Trust services: www.bartshealth.nhs.uk/pals

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Reference: BH/PIN/504

Publication date: April 2022

All our patient information leaflets are reviewed every three years.

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