Question of the Month – December 2020 Welcome to your Question of the Month - December 2020 December's question is written by: Ashlee Holman, MDAssistant Professor of AnesthesiologyUniversity of Michigan Health System A 16-year old male with sickle cell disease presents to the hospital in acute pain crisis. His sickle cell disease has worsened over the last few years, and optimal pain control during acute crises has been difficult to achieve. His analgesic regimen is complex and includes non-pharmacological methods (e.g. distraction techniques, behavioral modification therapy) as well as acetaminophen, NSAIDs, hydromorphone, methadone, and most recently, initiation of a lidocaine infusion. He reports low pain scores on the intravenous lidocaine and wonders if he can continue lidocaine in some form as an outpatient. The patient’s care team suggests transition to oral mexiletine as a replacement for intravenous lidocaine. Which of the following is false? A) Most patients should experience a significant decrease in pain scores with a dose of 450 mg/day. B) Total dose of mexiletine should be decreased in liver or kidney failure. C) Mexiletine can be discontinued without tapering. D) Patients who do not respond adequately to intravenous lidocaine infusion are unlikely to respond well to oral mexiletine treatment.