A randomized controlled trial of intravenous paracetamol and intravenous tramadol for labour analgesia

Abstract

Labour pain is among the most excruciating pain experienced by women. Pain relief during labour is expected to reduce maternal stress, improve maternal and perinatal outcome. Paracetamol and tramadol are easily available, inexpensive and easy administeration. The present study compared the efficacy of intravenous paracetamol and intravenous tramadol for labour analgesia. : A randomized controlled trial was conducted in the Department of Obstetrics and Gynaecology, Christian Medical College, Ludhiana including 130 patients divided into two groups. Group A received 1000 mg of intravenous paracetamol and Group B received 100 mg of intravenous tramadol hydrochloride for labour analgesia in active phase of labour (>/= 4 cm cervical dilatation). Pain intensity was assessed by Visual Analogue scale (VAS) before; after 1 and 3 hours of drug administration. Duration of labour, mode of delivery, drug-delivery interval, maternal side effects and neonatal outcomes were also assessed.Total 130 patients with 65 in each group were included. Pain intensity was assessed and it was observed that Mean VAS score was significantly lower after 1 and 3 hours of drug administration in Group A than Group B. Mean duration of 1 stage of labour (210.79+-70.49 minutes) and mean drug delivery interval (4.34 hours) was significantly lower in Group A than Group B (246.95+/-76.09 minutes; 5.17 hours). Maternal side-effects were observed more with tramadol than paracetamol.Intravenous paracetamol is more effective labour analgesic with lesser VAS score, shorter duration of labour, drug delivery interval and with few maternal side-effects.