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Intravenous paracetamol infusion versus intramuscular tramadol as an intrapartum labor analgesic

Hema Mohan, Rekha Ramappa, Sandesh M., Akash B. K..

Background: The objective of the study was to compare intravenous paracetamol and intramuscular tramadol as labor analgesics.
Methods: This prospective-randomized study conducted in 200 primigravidae in active labor, distributed into two groups of 100 women each with one receiving intravenous 1,000 mg Paracetamol and other 100 mg intramuscular tramadol. Pain intensity is recorded by McGills scale before, one and 3 h after drug administration. Perinatal outcome is recorded.
Results: No difference in pain intensity is seen before drug administration. After 1 h of drug administration, in paracetamol group, 4 % women had horrible pain, and 28 % had distressing pain, while in tramadol group, 30 % women had horrible pain, and 60 % had distressing pain. After 3 h of drug administration, in paracetamol group, 26 % had distressing pain, while in tramadol group, 50 % women had horrible pain, and 36 % had distressing pain. Labor duration in paracetamol and tramadol group was 4.6 and 6.0 h, respectively. In paracetamol group, nausea is seen in 2.2 % and vomiting in 1.1 %, while in tramadol group, nausea is seen in 6.4 % and vomiting in 4.3 %.
Conclusions: Intravenous paracetamol is more effective labor analgesic with fewer maternal adverse effects and shortens labor as compared to intramuscular tramadol.

Key words: Intramuscular tramadol, Intravenous paracetamol, Labor analgesic

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