Nurse Controlled Analgesia (NCA) - information for parents

Children who have good pain control tend to recover faster. This leaflet contains information about:

• What a NCA is.
• What side-effects to look out for.
• How a NCA controls your child’s pain safely.

What is a NCA?

NCA stands for ‘Nurse Controlled Analgesia’. This is a type of pain relief that lets the nurse administer pain medicine depending on your child’s needs if your child is unable to do this themselves. A small amount of pain medicine is given by pressing a button. The pain medicine we usually use is called Morphine, but there are other pain medicines that could be used. The doctor will decide which one is best for your child. All the pain medicines used in the NCA are strong which will help reduce your child’s pain.

How does it work?

A NCA machine contains pain medication in a syringe; this is connected to a tiny tube called a cannula. This cannula may be put in your child’s hand or arm whilst they are in the operating theatre. Connected to the machine is a handset with a button on it. When your child has pain or just before a painful procedure the nurse can press this button and the machine will give a small amount of pain relief medication through the cannula in to their vein. The machine may also be set so that a small continuous amount of pain relieving medicine is given all the time, in addition to the doses given when the button is pressed. The machine will be set especially for your child according to the doctor’s orders.

Is a NCA safe?

Yes, but it is very important that the nurse is the only person who presses the button. If someone else presses the button for your child it may make them too sleepy and very unwell. Your nurse will be checking their heart rate, breathing, pain level and how sleepy they are every hour. The nurse will assess your child’s pain using a pain assessment chart that is appropriate for their age and ability.

The machine has been specially set by the doctor or pain nurse specialist so that it will lock for a short period of time after the nurse has pressed the button; this is so that the pain relief medication is given time to work before your child can get some more and to help stop your child from having too much pain medication and becoming too sleepy.

Why can only a nurse press the button?

Only the nurse may press the button to deliver the pain relieving medicine because the nurse must first make an assessment of your child’s level of consciousness and pain to be sure it is safe and effective.

How will the NCA make your child feel?

Sometimes children have said that they feel itchy or sick. It is important that you let the nurse know how they are feeling so that the nurse can give them some other medicine to reduce these symptoms.

How long will your child need the NCA for?

This will depend on your child’s pain or the type of operation they have had. As your child gets better the button will need to be pressed less. Your child will be given other pain medicine such as Paracetamol alongside the NCA. When your child’s pain is improving and they are able to have other pain medicines, the NCA will be stopped.

Before stopping the NCA the nurse will assess your child to make sure pain is being controlled. Your child may need to continue some pain medicines when they get home.

Will your child get addicted to the pain medication in the NCA?

No, children do not become addicted to pain relieving medicine as it is being given to relieve pain from an operation or sickness. Usually your child will only need the pain medication through the NCA machine for a few days. If the NCA is used for more than a few days your child’s body may become used to the pain relieving medication, in this case the NCA may need to be reduced slowly.

What do you do if you are worried?

You know your child best and we rely on that knowledge. If you have any worries or questions about your child’s pain management then please talk to the nurse. You could also ask your child’s nurse to call the children’s pain team or an anaesthetist to come and talk to you.

Privacy & Dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and/or specialist one to one care is required.