ACUTE PAIN
MANAGEMENT:
Prescriber's
Guidelines
by Paul H. Willoughby, MD
Diane Santangelo, RN, MS, ANP-C
Associate Professor
Nurse Manager/Clinician Acute Pain Service
Director Acute Pain Service
These guidelines were developed for the use by Stony Brook University
Hospital’s Acute Pain Service.
PCA
First Line
MORPHINE: 5mg/cc (cartridges available on each unit.)
CONTINUOUS: May be helpful in young patients with extremely
painful surgeries (i.e., posterior spine fusion/multi-trauma, or patients
with prior narcotic requirements).
DEMAND: 1½-2 mg for young, 1 mg for elderly/obese
LOCKOUT: 6-8 mins, for young adult
10-15 mins, for elderly/obese
(and pts. with decreased cardiac output)
4-HOUR MAXIMUM: Calculate 4-5 demands/hour plus
continuous dose (after loading doses are given where
load = 1½ demand dose).
PEDIATRIC DOSING: 20 mcg/kg/demand
