IV paracetamol emerges as safer alternative to tramadol for labor pain relief :- Medznat
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Intravenous paracetamol vs. intramuscular tramadol: Which is better for labor analgesia?

Labor analgesia Labor analgesia
Labor analgesia Labor analgesia

What's new?

Intravenous paracetamol provides effective labor pain relief with fewer maternal side effects and better neonatal outcomes when compared to intramuscular tramadol.

In accordance with the findings of a trial conducted at a tertiary care hospital, intravenous (IV) paracetamol provides safe and effective intrapartum pain relief, with better maternal and neonatal outcomes compared to intramuscular (IM) tramadol. The study, which enrolled 9,945 primigravida women aged 18–30 years in spontaneous active labor with term, singleton, vertex pregnancies, aimed to investigate the efficacy and safety of IV paracetamol and IM tramadol as labor analgesics.

In this prospective randomized clinical trial, volunteers were randomly assigned into two groups: Group 1 received 1000 mg IV paracetamol, while Group 2 received 100 mg IM tramadol. Pain levels were checked via the visual analog scale (VAS) at baseline, 10 minutes, and 1 hour after administration. Labor outcomes, maternal side effects, and neonatal health parameters were systematically recorded and analysed.

Key findings

  • Pain relief: Both groups reported reduced pain levels. At 1 hour, women given tramadol experienced slightly greater relief (VAS 4.70 ± 0.86) as opposed to those given paracetamol (VAS 5.02 ± 0.78), a statistically significant difference (p = 0.0063).
  • Maternal safety: Women in the paracetamol group had fewer side effects, particularly vomiting (10% vs. 23%, p = 0.0222).
  • Neonatal outcomes: Babies born to mothers in the paracetamol group had higher Apgar scores at both 1 and 5 minutes (p = 0.0001 and p < 0.0001) and showed fewer cases of respiratory depression.
  • Mode and duration of labor: No pivotal differences were found between the groups.

While tramadol offered slightly better short-term pain relief, it was linked with higher rates of maternal side effects and less favorable neonatal outcomes. Researchers concluded that IV paracetamol is a safe, effective, and practical option for labor pain management, particularly in low-resource settings, given its ease of administration, availability, and stronger safety profile.

Source:

Authorea

Article:

Intravenous Paracetamol as a Safe and Effective Alternative to Intramuscular Tramadol for Labour Analgesia in Low-Resource Settings: A Randomised Controlled Study

Authors:

Rana Mondal et al.

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