Patient-controlled intravenous analgesia

Patient-Controlled Intravenous Analgesia (PCIA) puts you in control. You hold a button in your hand. When you need pain relief, press the button and a small amount of strong painkiller is delivered into a drip in your hand.

PCIA is sometimes used instead of an epidural for pain relief during labour. This may be your preference, or there may be reasons why you can’t have an epidural. The medicines used for PCIA are called remifentanil or fentanyl. You might hear these words used. PCIA may not be available on every labour ward.

The medicines used for PCIA act quickly but only for a short time. This makes them a good choice to help with the pain of contractions.

When asking women about different types of pain relief in labour, they say that PCIA is better than other painkiller injections (pethidine, morphine or diamorphine), but not as good as an epidural. Your experience may be different. It may be possible to continue to use gas and air as well as your PCIA.

Medicines used for PCIA can have some side effects:

• They can slow your breathing
• They can cause your oxygen levels to drop
• They can make you itchy
• They can make you feel sick
• They can make you feel sleepy.

These problems are usually easy to treat but mean that you will be monitored closely and may need some oxygen. Your anaesthetic doctor will review you if any of these problems happen. If there are any concerns that it is no longer safe to use a PCIA, the anaesthetic team will explain this to you and offer alternative pain relief options. These medicines have very little effect on your baby.
 

Not every labour ward offers PCIA pain relief. Ask your midwife what is available in your hospital. Your anaesthetic doctor will discuss pain relief with you, and help you make the best choice.