Publication:

Efficacy and safety of intravenous paracetamol versus intravenous tramadol for labour analgesia

Background An effective labour analgesia improves maternal and perinatal outcome and improves the course of labour.

Methods This was a prospective, randomised study done to compare effectiveness and safety of intravenous infusion of paracetamol with tramadol when used for labour analgesia. Group A (25 parturients) received paracetamol 1000 mg and group B (25 parturients) received tramadol 1mg/Kg at 4 to 6 cm cervical dilatation. Visual analogue score for pain was assessed at the baseline, 1 hour and 3 hours of drug administration and was compared between the two groups along with various maternal and fetal outcomes.

Results The difference in mean Visual Analogue Score (VAS) just before the drug administration was not statistically significant. However, at 1 hour of drug administration, mean VAS was significantly lower in the Group A (4.60) in comparison to Group B (5.82). The mean VAS at 3 hours was slightly lower in group A (6.35) in comparison to group B (6.65), though statistically there was no significant difference. Nausea, vomiting and sedation were found to be more in the tramadol group as compared to paracetamol group. The mean 1 and 5 minute apgar scores were found to be comparable in both the groups.

Conclusions So, it can be concluded from our study that intravenous paracetamol may be preferred over intravenous tramadol as it is associated with better analgesic efficacy and less maternal side effects. Although both the drugs were found to have good neonatal outcome.