Ｏｂｊｅｃｔｉｖｅ　To construct the patient-controlled intravenous analgesia (PCIA) nursing management protocol based on guideline and to explore its effect.　Methods　According to the guideline on postoperative pain management which was issued by the American Pain Society in 2016, the first draft of the PCIA nursing management protocol was constructed. Subsequently, the final draft of the management protocol was determined and implemented after experts′ consultation meeting. Patient′s satisfaction rates of analgesic service (PCIA), reasons for removal of PCIA, adverse effect rates of PCIA, patients′ satisfaction extent with adverse reaction management, the extent of complaining of pain control, and patients′ satisfaction rates with treatment of inadequate pain control were compared between two groups of patients before and after intervention.　Results　Comparing with the control group (350 patients), the patient′s satisfaction rate in experimental group (351 patients) with analgesic service was significantly improved. The number of patients with abnormal reasons for the early removal of PCIA was significantly reduced, and the proportion of patients complaining inadequate control of pain was increased significantly (P<0.05). There was no statistically significant difference between the two groups of patients in the incidence of adverse reactions of PCIA and patients′ satisfaction with the occurrence of adverse reactions or inadequate pain control (P>0.05).　Conclusions　Constructing the PCIA nursing management protocol based on guideline with nurses in the ward proposed as principal partners is suitable for routine operation. It can truly play the role of nurses in postoperative pain management, improve postoperative pain management quality and patients′ satisfaction, also provide patients with safe and effective analgesic service.