Publication:

Comparison of parenteral tramadol and epidural ropivacaine for labour analgesia: a prospective clinical study

Background The pain of childbirth is one of the most severe types of pain that a woman experiences in her lifetime. Adequate analgesia during labour has a positive influence on the course of labour. For labor analgesia several non-pharmacologic and pharmacologic methods are adopted. The objective of the study is to compare parenteral tramadol and epidural ropivacaine with regard to maternal and labour outcome.

Methods This prospective, comparative, interventional clinical study was conducted at Kasturba Hospital, Daryaganj, Delhi, on the patients admitted in the labour room of the hospital during the period of September 2014 to July 2015. Various parameters of maternal condition and labour outcome in each group were monitored and compared. These included the degree of pain relief and patient satisfaction, duration of 1st and 2nd stage of labour, mode of delivery and duration of third stage and any third stage complication like post-partum haemorrhage (PPH) and retained placenta and side effect profile of both the drugs.

Results Epidural ropivacaine has significantly better analgesic efficacy and faster onset of action as compared to I/M tramadol and patients in epidural group were significantly better satisfied. Ninety-two percent of patients in tramadol group and eighty eight percent in epidural group underwent normal delivery. Duration of the three stages of labour, complications of third stage and side effect profile in both the groups were comparable.

Conclusions Maternal outcome in labour analgesia is similar with 100 mg I/M tramadol and epidural ropivacaine. There is no significant difference between duration of labour, rate of LSCS, incidence of instrumental delivery and neonatal outcome in the two modes of analgesia. Analgesic efficacy with epidural ropivacaine seems to be better compared to intramuscular tramadol.