{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:52:02Z","timestamp":1791399122198,"version":"4.3.3"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T00:00:00Z","timestamp":1604016000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>We evaluated the ability of intravenous (IV) acetaminophen to reduce the amount of opioid medication administered in pediatric patients with sickle cell disease (SCD) having vasoocclusive crisis (VOC) in an emergency department (ED) setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective, randomized, double\u2010blind placebo\u2010controlled trial at an academic urban pediatric ED. Participants included patients with SCD, aged 4 to 16\u00a0years, with VOC pain. All patients received a 0.1\u00a0mg\/kg dose of IV morphine, 0.5\u00a0mg\/kg ketorolac, or both. Patients were randomized to receive either 15\u00a0mg\/kg IV acetaminophen or placebo. Patients were reassessed every 30\u00a0minutes to see whether additional opioid doses were indicated to a maximum of three doses. The total morphine given, pain scores, rates of admissions, 72\u2010hour return visits, and adverse events were assessed for each group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 71 subjects randomized, 35 patients in the acetaminophen group and 36 patients in the control group were analyzed. Baseline characteristics and initial pain scores were similar in both groups. The mean total amount of morphine given was 8.6\u00a0mg (95% confidence interval [CI]\u00a0= 6.5 to 10.8) in the acetaminophen group and 8.0\u00a0mg (95% CI\u00a0= 5.9 to 10.2) in the placebo group. The mean total cumulative morphine dosing was 0.2\u00a0mg\/kg (95% CI\u00a0= 0.1 to 0.2 mg\/kg) in the acetaminophen group and 0.2\u00a0mg\/kg (95% CI\u00a0= 0.1 to 0.2\u00a0mg\/kg) in the control group. The mean pain score at time of disposition was 5.5 (95% CI\u00a0= 4.3 to 6.6) in the acetaminophen group and 5.2 (95% CI\u00a0= 4.2 to 6.3) in the placebo group. There were no clinical or statistically significant differences between the rates of admission, 72\u2010hour return visits, or adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this study, patients who received IV acetaminophen did not receive less morphine than patients in the placebo group. Disposition pain scores for the two groups were also equivalent. We conclude that IV acetaminophen, when used in addition to morphine for pediatric sickle cell VOC pain, does not provide an opioid\u2010sparing effect. Further searches for adjunctive nonaddictive pain medicines are indicated.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14149","type":"journal-article","created":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T05:35:02Z","timestamp":1602048902000},"page":"639-646","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Does Intravenous Acetaminophen Reduce Opioid Requirement in Pediatric Emergency Department Patients With Acute Sickle Cell Crises?"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7719-2053","authenticated-orcid":false,"given":"Tina","family":"Dhebaria","sequence":"first","affiliation":[{"name":"From the Pediatric Emergency Department Children\u2019s Hospital of New Jersey at Newark Beth Israel Medical Center Newark NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Sivitz","sequence":"additional","affiliation":[{"name":"From the Pediatric Emergency Department Children\u2019s Hospital of New Jersey at Newark Beth Israel Medical Center Newark NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cena","family":"Tejani","sequence":"additional","affiliation":[{"name":"From the Pediatric Emergency Department Children\u2019s Hospital of New Jersey at Newark Beth Israel Medical Center Newark NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,30]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"National Heart Lung and Blood Institute.Evidence Based Management of Sickle Cell Disease Expert Panel Report.2014. Available at:https:\/\/www.nhlbi.nih.gov\/health\u2010topics\/evidence\u2010based\u2010management\u2010sickle\u2010cell\u2010disease. Accessed Mar 22 2020."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-1-4377-1155-4.00053-5"},{"key":"e_1_2_8_4_1","unstructured":"BallasS GuptaK Adams\u2010GravesP.Sickle Cell Pain: A Critical Reappraisal. Department of Medicine Faculty Papers. Paper 8.2012. Available at:http:\/\/jdc.jefferson.edu\/medfp\/81. 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