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Intravenous Paracetamol Infusion Versus Intramuscular Tramadol as an Intrapartum Labour Analgesic

Srinivas Rapolu, Associate Professor, Department of Anesthesiology, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar, Telangana 505001, India. , Srinivas Rapolu1 , A. Srikanth Reddy2 , Syed Ali Aasim3

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Indian Journal of Anesthesia and Analgesia 4(3):p 593-597, July - September 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.7

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Abstract

Aim: To compare between intravenous administration of paracetamol and intramuscular tramadol as a labour analgesic. Methods: The present study is a prospective randomised study conducted in 150 primigravida women for a period of 7 months. Inclusion criteria were primigravida with full-term pregnancy in the age group 20-30 years with spontaneous onset of labour with single fetus with vertex presentation in active phase of labour. Active phase of labour was described as cervical dilatation more than or equal to 3 cm, cervical effacement more than or equal to 60% and good uterine contractions. The women were randomly distributed in two groups, Paracetamol group A-75 women and Tramadol group B-75 women after taking informed consent. Mc Gills pain intensity scale was used to measure the pain intensity. Results: No significant difference was observed before drug administration in the pain intensity. 2.6% women had horrible pain, and 16% had distressing pain in paracetamol group, while in tramadol group, 21.3% women had horrible pain and 60% had distressing pain after 1 hour of drug administration. After 4 hours of drug administration, in paracetamol group, 16% had distressing pain while in tramadol group, 48% had horrible pain and 40% had distressing pain. In paracetamol group, labour duration was 5.0 hours whereas in tramadol group, it was 6.1 hours. In paracetamol group, nausea was seen in 2.0% and vomiting was seen in 1.5% whereas in tramadol group, nausea was seen in 7.0% and vomiting was seen in 4.1%. Conclusion: It can be concluded from this study that intravenous administration of paracetamol is simple, feasible and cost effective and more effective labour analgesic when compared to intramuscular tramadol. Paracetamol has a better analgesic activity, shortening of labour duration and very less side effects.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.7

Keywords

Mc Gills Pain Intensity Scale; Paracetamol; Tramadol.

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