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Analgesic efficacy of intravenous paracetamol versus intravenous tramadol after caesarean section: a single blind randomized controlled study

Kumari Usha Rani, Vijay Zutshi, Madhumita Patel, Sheeba Marwah.

Abstract
Background: Caesarean section is one of the commonest surgeries performed in obstetrics. Adequate management of postoperative pain leads to early mobilization and proper newborn care. The purpose of this study was to compare the analgesic efficacy and side effect profile of Paracetamol versus Tramadol in women undergoing caesarian section.
Methods: A single-blind randomized controlled interventional study was conducted in Department of Obstetrics and Gynecology, Vardhman Mahavir Medical College and Safdarjang Hospital, New Delhi over a period of six months from May 2015 to Oct 2015. 100 women undergoing caesarean section under spinal anaesthesia were divided in two groups (50 in each group) using computer generated randomization. One group received Intravenous Paracetamol 1000 mg and another group Intravenous Tramadol 50 mg. The drugs were given 8 hourly for 24 hours. The primary outcome measures were the degree of pain relief during the entire observation period by doing visual analogue scale (VAS) scoring and need of rescue analgesia if any (administered if the VAS score >6); secondary outcome measures were side effects on mother and baby.
Results: The pain scores were low in both groups across various time interval except at 6 hours in Paracetamol group (p=0.673) and at 8 hours in Tramadol group (p=0.194). Requirement for rescue analgesia was comparable in both the groups (16% vs. 10%, p = 0.372). However maternal side effects were more in Tramadol group (8% vs. 34%, p = 0.001).
Conclusions: Both Paracetamol and Tramadol achieve satisfactory pain control after caesarean section but Tramadol causes significant side effects in mother compared to paracetamol.

Key words: Analgesia, Caesarean section, Paracetamol, Tramadol


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