Randomized Trial Evaluating Lidocaine Intravenous in the Emergency Department For Sickle Cell Crisis – RELIEF-SCC

About the study

Sickle cell crisis continues to be a frequent presentation to emergency departments. Patients
presenting will often require immediate treatment for their pain and often times this will
include opioids. The opioid epidemic has cost thousands of lives; and continues to be a
significant problem posing several challenges when treating patients presenting with sickle
cell disease. Primarily, opioids remain the mainstay of treatment for these patients and the
push to address the opioid crisis may present challenges for adequate opioid administration
in patients suffering from a sickle cell crisis while hospitals find ways to curb the opioid
crisis overall. Opioid treatment for patients in acute vaso-occlusive crisis has
significantly contributed to quality of life and life expectancy of patients with this
diagnosis. Measures should continue to attempt to administer a multi-model approach to sickle
cell patients to minimize the morphine milligram equivalents in these patients while also
successfully addressing the patient’s pain. IV lidocaine is a pain medication that has been
evaluated in several painful experiences, such as in renal colic. A few case reports have
shown IV lidocaine use in sickle cell can be a potential effective adjunct medication to
opioids to treat pain and reduce further opioid requirements. Currently, no prospective
controlled trial exists to evaluate the true benefit of IV lidocaine in this population. Our
study aims to evaluate IV lidocaine as an adjunct to opioid treatment in the emergency
department to determine if improved pain is achieved and if there is a reduction in overall
morphine milligram equivalents throughout the emergency department visit.