Patient-Controlled Analgesia in ICU: A Scoping Review

Background/Objectives: Patient-Controlled Analgesia (PCA) is a well-established strategy for managing postoperative pain, but its use in the Intensive Care Unit (ICU) remains poorly defined, poorly standardized, and fragmented. The aim of this scoping review is to map the extent, nature, and characteristics of the available evidence on the use of PCA in ICU patients, identifying key areas of uncertainty and knowledge gaps that require further study. Methods: Scoping review reported according to the PRISMA-ScR guidelines. Results: 12 relevant studies were identified. Available evidence suggests that PCA can provide pain control comparable to traditional techniques in post-cardiac surgery patients in the ICU, while data on its use in non-surgical patients are limited. The studies reported good feasibility and a generally favorable safety profile, with a low incidence of significant respiratory events thanks to intensive monitoring. Methodological variability prevents direct comparisons between studies. Conclusions: PCA supports personalized pain management based on patient-specific clinical conditions and response. However, more standardized studies are needed to define its role.