Comparison of analgesic efficacy of paracetamol and tramadol for pain relief in active labor

• Published in: Journal of clinical anesthesia 2015-03, Vol.27 (2), p.159-163
• Main Authors: Kaur Makkar, Jeetinder, MD, DNB, Jain, Kajal, MD, Bhatia, Nidhi, MD, DNB, Jain, Vanita, MD, Mal Mithrawal, Sanwar, MD
• Format: Article
• Language: English
• Subjects: Acetaminophen - administration & dosage; Acetaminophen - adverse effects; Active labor; Adult; Analgesia; Analgesia, Obstetrical - adverse effects; Analgesia, Obstetrical - methods; Analgesics; Analgesics, Non-Narcotic - administration & dosage; Analgesics, Non-Narcotic - adverse effects; Analgesics, Opioid - administration & dosage; Analgesics, Opioid - adverse effects; Anesthesia & Perioperative Care; Body mass index; Childbirth & labor; Double-Blind Method; Drug Administration Schedule; Drug dosages; Drug therapy; Female; Heart rate; Humans; Infusions, Intravenous; Injections, Intramuscular; Labor, Obstetric; Narcotics; Nausea; Pain - prevention & control; Pain management; Pain Measurement - methods; Pain Medicine; Paracetamol; Pregnancy; Prospective Studies; Side effects; Tramadol; Tramadol - administration & dosage; Tramadol - adverse effects; Vomiting; Young Adult
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2014.08.008

Abstract Study Objective To evaluate the efficacy and safety profile of paracetamol in comparison with tramadol for pain relief during active labor. Design Prospective, randomized, double-blind study. Setting Maternity Wing of the Postgraduate Institute of Medical Education and Research, Chandigarh. Patient Sixty laboring, primiparous, full-term parturients with uncomplicated, singleton pregnancy in spontaneous labor and cervical dilatation of 3-5 cm. Intervention Parturients were randomized into 2 groups to receive either 1 mg/kg of tramadol intramuscularly (group T; n = 29) or 1 g of paracetamol intravenously (group P; n = 30). Same doses of the drugs were repeated after 4 hours of initial dose. Measurement Primary outcome of the study was to assess the analgesic efficacy of the 2 drugs as measured by visual analog scale (VAS) score. Secondary outcome recorded was duration of labor, presence of any maternal, or fetal adverse events during the study. Results Both the groups showed comparable VAS scores at all times of observation. Lower mean VAS scores were reported in both the groups till 120 minutes only. The duration of first stage of labor was shorter in group P (248.00 ± 98.171 vs 340.63 ± 111.592 minutes; P = .003). The duration of second stage of labor was comparable between the 2 groups. Higher incidence of maternal side effects such as nausea/vomiting and sedation was associated with the use of tramadol. Neonatal outcome was comparable. Conclusion Intravenous paracetamol provides comparable analgesia as intramuscular tramadol during active labor.