Patient Controlled Analgesia Titration How to Titrate: • Opioid Naive: No basal rate • Chronic Opioid Use: Set the basal rate at equianalgesic dose of chronic opioid Parameters: • Calculate basal rate (if needed) • Incremental dose: 50-100% of basal rate • Lockout: 8 to 10 minutes (6 minutes for fentanyl) • Loading: Twice the incremental dose (10% of 24-hour dose) Adjustments: • Can change incremental dose every 30-60 minutes (great for acute pain, and rapid titrations) • Mild to moderate pain: increase dose 25-50% • Moderate to severe pain: increase dose 50-100% • Change basal rate every 8 hours as needed (but don't change more than 100% at a time) - Dr. Kevin Braghirol @KBrag_MD #PCA #PatientControlled #Analgesia #Titration #management
