Comparison of analgesic efficacy of paracetamol and tramadol for pain relief in active labor.
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.
['Kaur Makkar|Jeetinder|J|', 'Jain|Kajal|K|', 'Bhatia|Nidhi|N|', 'Jain|Vanita|V|', 'Mal Mithrawal|Sanwar|S|']
D000082:Acetaminophen D000328:Adult D016362:Analgesia, Obstetrical D018712:Analgesics, Non-Narcotic D000701:Analgesics, Opioid D004311:Double-Blind Method D004334:Drug Administration Schedule D005260:Female D006801:Humans D007262:Infusions, Intravenous D007273:Injections, Intramuscular D007743:Labor, Obstetric D010146:Pain D010147:Pain Measurement D011247:Pregnancy D011446:Prospective Studies D014147:Tramadol D055815:Young Adult
Paracetamol Tramadol Active labor Side effects Analgesia