Publication:

A comparative study of intrapartum epidural analgesia with intramuscular tramadol on labor outcome

Background Epidural analgesia produces analgesia in labour without affecting nervous system, allows the mother to be well oriented, fully conscious and alert throughout labour. The aim of this study is to study the effect of epidural analgesia and intramuscular (IM) tramadol in different stages of labour and compare the effect of epidural analgesia with intramuscular tramadol on progress of labour and its outcome.

Methods Continuous monitoring of the haemodynamic parameters of the mother was done using multiparameter monitors. Foetal monitoring was done using continuous cardiotocography (CTG) monitor. Primigravida in spontaneous labour were randomly divided into two groups. Group I received epidural analgesia and group II received IM tramadol.

Results Duration of Ist stage of labour in group I was 167.0±47.2 min and in group II was 214.4±50.2 min. Mean duration of III stage of labour in the present group I was 7.9 min and 7.5 min in the group II. In the present study, total duration of labour is shortened by 47 min in group I compared to group II.

Conclusions Epidural analgesia during labour is a simple and effective method for painless and safe delivery. Analgesia produced by epidural route is significantly more effective than intramuscular tramadol. Epidural analgesia has favourable effect on the progress of labour. In developing nations where availability of facilities is the main limiting factor, intramuscular tramadol which is a safe and satisfactory drug for relief of labour pain, can be considered as a suitable alternative.