Comparative Study between Intravenous Paracetamol and Intramuscular Tramadol as Labour Analgesic

Purpose This study was done to compare the efficacy of intravenous paracetamol and intramuscular tramadol injection as labour analgesic. Method This prospective-randomized study was conducted in 200 primigravidae at term pregnancy in active labour, distributed into two groups of 100 women each receiving single dose of intravenous 1000mg Paracetamol and other 100mg intramuscular tramadol. Pain intensity was recorded by Visual Analogue Scale before, one and three hours after drug administration. Labour events were recorded in partograph. Perinatal outcome and maternal complications were observed. Results VAS score was divided into four parts no pain (VAS score 0cm), mild pain (VAS score 0.1-3.9cm), moderate pain (VAS score 4-6.9cm) and severe pain (VAS score 7-10cm). Difference in pain intensity was absent before drug administration. After 1 hour of drug administration, in paracetamol group, severe pain 32.7 %, moderate pain 57.1 % and mild pain 10.2 %. In tramadol group, severe pain 52 %, moderate pain 44.9 % and mild pain 3.1 %. After 3 hours of drug administration, in paracetamol group, severe pain 37.8 %, moderate pain 46.9 % and mild pain 15.3 %. In tramadol group, severe pain 58.2 %, moderate pain 39.8 % and mild pain 2.04 %. Differences in the VAS score between the groups were statistically significant. Mean labour duration in paracetamol and tramadol group 4hrs38min51.25mins and 5hrs42mins58.16mins respectively. Complications in paracetamol group, 5 % nausea, 2 % vomiting and 5 % PPH (mainly traumatic) while in Tramadol group, 9 % nausea, 5 % vomiting and 3 % PPH and 1 NICU admission in tramadol group Conclusion Intravenous paracetamol is a more effective labour analgesic. It shortens labour with fewer maternal and foetal adverse effects as compared to intramuscular tramadol.