Table 1.

Summary of findings on the different analgesic regimens used in SCD painful crisis

Study	Analgesic regimen	Route of administration (mode of analgesia)	Findings
• Conti et al46	• Morphinea	• Oral (unimodal)	• Reduction in the number of ED consultations, total number of hours spent in the ED, and proportion of consultations ending with hospital admissions
• Tawfic et al13	• Morphine and other adjuvant analgesics • Plus low-dose ketamine– midazolam regimenb	• Intravenous (multimodal)	• Significant improvement in pain scores of adult SCD patients in severe painful crisis
• Telfer et al48	• Diamorphinec • Morphine	• Intranasal • Intravenous/oral (multimodal)	• Rapid improvement in pain scores within 2 hours in pediatric SCD patients with painful crisis in an ED
• Brookoff and Polomano49	• Morphine	• Intravenous • Oral controlled-release (unimodal)	• Reduction in number of admissions for pain by 44%, total inpatient days by 57%, hospital LOS by 23%, and ED visits by 67%
• Buchanan et al51	• Nalbuphine hydrochlorided	• Parenteral by PCA (unimodal)	• Reduction in hospital LOS • Prevented ACS

Notes:

^aStrong opioid;

^badjunct treatment;

^calso known as heroin (more potent than morphine)

^dopioid with similar pain-relieving potency to morphine.

Abbreviations: ACS, acute chest syndrome; ED, emergency department; LOS, length of stay; PCA, patient-controlled analgesia; SCD, sickle cell disease.