DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20210326

An observational study of parenteral paracetamol vis a vis tramadol as labour analgesics

Pallavi Viswanadh, Supraja Subramanian, Himadri Bal

Abstract


Background: Labour although a physiological process, is associated with severe, excruciating pain. The delivery of the infant into the arms of a conscious and a pain free mother is one of the most exciting and rewarding moments in medicine ……..Moir. Labour analgesia plays an important role in making the process of labour comfortable for the mother. Drugs like paracetamol and tramadol with advantages of easy availability, being inexpensive and with no special technique of administration are a boon for labour analgesia. Our study aims to evaluate the efficacy of these two drugs as labour analgesics.

Methods: Sixty cases in active labour fulfilling inclusion and exclusion criteria were selected for this study. All primigravidae at term gestation with singleton pregnancy having vertex presentation with no associated obstetric/ medical/surgical risk factors in spontaneous labour were selected. There were thirty patients who received Paracetamol as labour analgesic and thirty were in the tramadol group. It was an observational study.

Results: The study revealed that paracetamol had a significant analgesic effect compared to tramadol at the fourth and the fifth hour of administration. However, the overall analgesic effect of both the drugs had no statistically significant difference. Maternal side effects and neonatal distress were less with paracetamol.

Conclusions: This study showed that paracetamol had a better side effect profile for both mother and neonate along with a comparable, if not better, analgesic effect vis a vis tramadol.


Keywords


Analgesia, Labour, Pain, Paracetamol, Relief, Tramadol

Full Text:

PDF

References


Mulder EJ, De Medina PR, Huizink AC, Van den Bergh BR, Buitelaar JK, Visser GH. Prenatal maternal stress: Effects on pregnancy and the (unborn) child. Early Hum Develop. 2002;70(1-2):3-14.

Brownridge P. The nature and consequences of childbirth pain. Eur J Obstet Gynecol Reprod Biol. 1995;59:S9-15.

Beilin Y. Advances in labor analgesia. Mount Sinai J Med. 2002;69(1-2):38-44.

Brown ST, Douglas C, Flood LP. Women’s evaluation of intrapartum nonpharmacological pain relief methods used during labor. J Perinat Educ. 2001;10(3):1-8.

Block BM, Liu SS, Rowlingson AJ, Cowan AR, Cowan Jr JA, Wu CL. Efficacy of postoperative epidural analgesia: a meta-analysis. JAMA. 2003;290(18):2455-63.

Moore J. The effects of analgesia and anaesthesia on the maternal stress response. In: Effects on the baby of maternal analgesia and anaesthesia. WB Saunders: London; 1993:148-162.

Jarnbert-Pettersson H, Vixner L. Labour Q1 pain- poorly analysed and reported: a systematic review. BMC Pregnanc Childbirth. 2018;18:483(1-9).

Sharma CV, Mehta V. Paracetamol: mechanisms and updates. Continuing Educ Anaesth Crit Care Pain J. 2014;14(4):153-8.

Patil S, Somashekara SC, Goud GKV, Bhanurekha S, Reddy LJ, Deepalaxmi S. Tramadol analgesia in labour. Int J Pharm Biomed Res. 2012;3(1):49-51.

Dayer P, Desmeules J, Collart L. Pharmacology of tramadol. Drugs 53 (1997):18-24. Obstet Gynecol Res Drugs. 1997;53(2):18-24.

Das BP, Ali J, Baruah A. Comparative study between intravenous paracetamol and intramuscular tramadol as labour analgesic. Int J Sci Res. 2016;5(10):1675-9.

Mohan H, Ramappa R, Sandesh M, Akash BK. Intravenous paracetamol infusion versus intramuscular tramadol as an intrapartum labor analgesic. Int J Reprod Contracept Obstet Gynecol. 2015;4(6):1726-9.

Lallar M, ul Haq A, Nandal R, Singh SP, Katyal S. Intravenous paracetamol infusion versus intramuscular tramadol as an intrapartum labor analgesic. J Obstet Gynaecol India. 2015;65(1):17-22.

Conell-Price J, Evans JB, Hong D, Shafer S, Flood P. The development and validation of a dynamic model to account for the progress of labor in the assessment of pain. Anesth Analg. 2008;106(5):1509-15.

Makkar JK, Jain K, Bhatia N, Jain V, Mithrawal SM. Comparison of analgesic efficacy of paracetamol and tramadol for pain relief in active labor. J Clin Anaesth. 2015;27(2):159-63.

Abhinaya A, Latha K, Jayashree V. Comparative study between intravenous paracetamol and intramuscular tramadol as labour analgesia. Int J Curr Med Pharm Res. 2017;3(10):2491-6.

Abdollahi MH, Mojibian M, Pishgahi A, Mallah F, Dareshiri S, Mohammadi S, et al. Intravenous paracetamol versus intramuscular pethidine in relief of labour pain in primigravid women. Niger Med J. 2014;55(1): 54-7.

Andey AK, Aleenasibi, Ullagantisaichaitanya, Mohanta GP, Sangeereni M. Study on use of intramuscular tramadol as analgesic during labour. IOSR J Pharm Biol Sci. 2018;13(4):73-9.