Patient-controlled analgesia (PCA) is any method of allowing a patient in pain to administer his/her own pain relief. PCA is equipped with a computerized pump which is often used by patients recovering from surgery. It is employed for post-operative management. Its method of pain control provides patients with the power to control their pain. PCA is also beneficial for patients who find difficulty taking medication by mouth. Some of the drugs administered by PCA infusion are morphine, hydromorphie, and fentanyl. PCA pump is a computerized pump that contains a syringe of medication, which delivers a small amount of medication in a constant flow. In some cases, the dose is set and an additional dose can be administered by patients themselves just by pressing a button. It is easy to be used by parents and nurses for children aged 6 years or below. Key advantages of PCA include greater patient satisfaction, fewer post-operative complications, less sedation, improved quality of recovery, and less use of medication (as doses are set). Disadvantages include possibility of underdose or overdose of medication, nurse assistance required in case of children aged less than 5 years, difficulty to use in patients that are critically ill (as it may cause nausea, itching, and constipation).
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The patient-controlled analgesia can be administered by any of these routes: oral, intravenous, epidural, inhaled, nasal spray, and transcutaneous. Patient-controlled analgesia is most commonly used for intravenous opioid demand dosing. Epidural PCA is administered in the epidural space to women in labor and ill cancer patients. Oral PCA is for an over-the-counter or prescription drug. In 1968, Abbott Lab. developed an inhaler device called Analgizer. It was observed to be safe and effective in obstetric and bone fracture patients. In transcutaneous delivery, iontophoretic systems are used. PCA has two modes of administration viz. demand dosing and continuous infusion. Furthermore, demand dosing has variables viz. demand dose, initial loading dose, lockout interval, infusion rate, and 1-hour and 4-hour limits. A highly undesirable event associated with PCA is PCA with proxy (when someone other than the patient presses the button).
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The primary factors which sustain the demand for PCA infusion pumps is technological advancements; rising incidence of chronic illnesses such as pain, diabetes, and cancer; advanced safety features; favorable reimbursements; portability of the system; scope for infusion of multiple medications at the same time. A major factor hampering the demand is patient medication errors with infusion pumps leading to product recalls. Secondly, lack of awareness about using advanced infusion systems and strict regulations imposed on product approval are likely to hamper the market. Based on geography, the PCA pumps market has been segmented into China, the U.S., Europe, Japan, Southeast Asia, and India. Based on product, the market has been divided into electronic PCA pumps and mechanical PCA pumps. Based on end-user, the market has been segregated into ambulatory surgical centers, hospitals, home care setting, and others. Based on application, the market can be segmented into diabetes, cancer, pain, and others.
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The market in Asia Pacific excluding Japan (APEJ) is led by India and China, due to rising demand for health care, increase in the incidence of chronic diseases, and awareness about new health care technologies in the two countries. North America holds the largest market share. However, recently, the market share held by North America has slightly decreased due to saturation of devices in the region. The market in Europe is expanding due to growing elderly population and recovery of the region from economic crisis. Among end-users, the hospitals segment dominates the global market and the trend is expected to continue until 2026. On basis of product Mechanical PCA over normal PCA have fine adjustment of parameter and record is automatically saved. But it have certain drawback like preparation of the equipment and drug, observation of patient condition, changing of various setting, data extraction.
Top players operating in the patient-controlled analgesia (PCA) pumps market are Smiths Group plc, Baxter International, Ace Medical Co. Ltd, Hospira (Pfizer Inc.), Fresenius Kabi Group, Terumo Corporation, Becton Dickinson (BD Alaris™), and Micrel Medical Devices.
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