Roni Wilson

Date of Award


Document Type

Independent Study

Degree Name

Master of Science (MS)




Patient controlled epidural analgesia (PCEA) allows patients to self- administer precise doses of opioid/ local anesthetic directly into the epidural space on an as needed basis. The majority of PCEA is used with maternal patients in the pre-partal period and Certified Registered Nurse Anesthetists (CRNA) are the primary individuals who assess and prescribe these medications. This independent project explored the current research published on PCEA. Topics covered included: risks and benefits of the prescribed medications, dosaging, options for basal (background) rate and/or patient controlled analgesia (PCA) patient satisfaction, benefits to fetus, procedures where PCA may be indicated, and contraindications of PCEA. A physiologic pain theory framework guided the paper. Questions addressed included: 1) What is the current state of pain controlled epidural analgesia research and recommendations for practice? 2) What medication combinations are being used to obtain optimal pain control? 3) Is there a need for background infusion rates? 4) Are there identified complications of PCA epidurals? 5) What are the benefits of having patient controlled epidural analgesia? 6) Is patient satisfaction increased with the addition of the PCA component? The independent study concludes with an analysis of best practices and present guidelines for CRNA’s to use when prescribing epidural analgesia. Finally recommendations for nursing practice, education, research and policy are presented.