Badanie szybkości i skuteczności methoxyflurane w porównaniu z oxycodone hydrochloride i morphine sulfate u pacjentów z chorobą sierpowatą w kryzysie vaso‑oklusyjnym

Enrollment and randomisation

After signing the consent form, basic information such as age, sex and medical history of sickle cell disease is recorded.

The patient is randomly assigned to receive either methoxyflurane inhalation or an oral opioid (morphine sulfate 20 mg or oxycodone hydrochloride 10 mg).

Initial analgesic administration

If the patient is allocated to the inhaled Group, a single dose of 6 ml methoxyflurane is given through a small inhaler; the medication is breathed in until the dose is finished.

If the patient is allocated to the oral opioid Group, one tablet containing either 20 mg morphine sulfate or 10 mg oxycodone hydrochloride is taken by mouth.

The first dose is given as soon as possible after arrival at the emergency department.

Pain intensity monitoring

Pain is measured with a visual analog Scale (VAS), a line where 0 means no pain and 10 means worst possible pain.

The patient marks the level of pain every 10 minutes for the first hour after the initial medication.

At the 60th minute, the patient also rates overall satisfaction on a likert Scale from 1 (very dissatisfied) to 10 (very satisfied).

Additional analgesic treatment if needed

If pain remains high, further medication may be given intravenously, such as morphine, or orally, such as nefopam, paracetamol or tramadol.

The total amount of these drugs is recorded until the patient leaves the emergency department.

Nurse satisfaction Assessment

Within the first 8 hours, the attending nurse rates satisfaction with the pain‑relief process on a likert Scale from 1 to 10.

Hospital stay and discharge

The length of stay, counted from arrival at the emergency department until discharge from the hospital, is recorded in days.

The number of methoxyflurane bottles used or the number of oral opioid tablets taken is noted for cost calculation.

Follow‑up safety assessments

Blood tests to evaluate kidney and liver function are repeated between the third and seventh day of hospitalization; the worst value is used for safety analysis.

The patient is monitored for possible complications such as acute chest syndrome, stroke or other neurologic events during the hospital stay.