Evidence-based guidelines and expert panels recommend the following in the management and treatment of pain crisis:

• Initiate analgesia within 30 minutes of triage. (Consensus – Panel Expertise)
• Employ individualized prescribing and pain monitoring protocols. (Consensus – Panel Expertise)
• If no contraindications, give NSAIDs as adjuvant pain therapy. (Moderate Recommendation, Low-Quality Evidence)
• Avoid meperidine (pethidine) (normeperidine, the active metabolite of meperidine, is excreted by the kidneys, and is associated with an increased incidence of seizures in the setting of renal dysfunction – common in occlusive crisis)