BACKGROUND High rates of uncontrolled pain in critically ill patients remain common. Patient-controlled analgesia is more effective than traditional intravenous as-needed dosing regimens for managing postoperative pain in older children and adults. OBJECTIVE To determine whether pain-related clinical outcomes in patients from age 10 years to adult following cardiac surgery are improved by using patient-controlled analgesia as a pain management strategy. METHODS Using the plan-do-study-act method of quality improvement, a process was instituted to have both staff and patients' families support the use of patient-controlled analgesia postoperatively as opposed to traditional pain control with as-needed analgesics. Use of as-needed medications and pain scores were retrospectively compared from before to after initiation of patient-controlled analgesia. RESULTS The cumulative mean pain score from the time of extubation through the following 24 hours decreased from 4.14 (on a scale from 0 to 10) when strictly as-needed medications were used to 2.8 with patient-controlled analgesia. Further, the mean amount of opioid consumed decreased from 14.98 mg of morphine and 22.27 mg of oxycodone to 13.58 mg of morphine and 3.33 mg of oxycodone after implementation of patient-controlled analgesia. CONCLUSIONS Standardized use of patient-controlled analgesia for postoperative pain management in patients 10 years of age through adulthood is efficient and effective, as evidenced by less medication being consumed by patients and lower mean pain scores. 1 The challenge in pain management can include, but is not limited to, insufficient knowledge of pediatric pain and pain pathway development, uncertainty about appropriate dosages of analgesics in children, and difficulty assessing both pain and adequacy of analgesia in children, as well as adults.2,3 Currently, few published reports describe investigation of pain management strategies to improve pain-related outcomes in children and adults following CE 1.0 hour, CERP A This article has been designated for CE contact hour(s). The evaluation tests your knowledge of the following objectives: 1. Identify potential barriers to postoperative pain management in patients 10 years of age through adulthood 2. Compare the use of as-needed pain medication for postoperative pain to the use of patient-controlled analgesia 3. Evaluate the importance of accurate reporting and documenting of pain scores

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