Ibuprofen versus acetaminophen for the relief of perineal pain after childbirth: a randomized controlled trial.
OBJECTIVE
To evaluate efficacy of ibuprofen compared with acetaminophen for relief of perineal pain after childbirth, side effects of ibuprofen compared with acetaminophen and patient satisfaction in treatment between the 2 groups.


METHODS
A total of 210 women who gave birth by spontaneous vaginal delivery with mediolateral episiotomy between June 2006 and November 2006 were randomly assigned to receive either ibuprofen (400 mg) (n = 106) or acetaminophen (1000 mg) (n = 104), both given orally when suturing was completed. Pain ratings were recorded before the treatment and at 1, 2, 3 and 4 hours after the treatment on a 10-cm visual analogue scale. Side effects and patient satisfaction were assessed at 24 hours.


RESULTS
Pain in the ibuprofen group was considerably more reduced than the acetaminophen group at 1 hour of treatment (mean pain rating 2.18 vs. 2.88, respectively; p < 0.003). Even though, at 2, 3 and 4 hours of treatment ibuprofen seemed to give more reliefof pain than acetaminophen, they did not reach statistically significant differences (mean pain rating; at 2 hour: 1.59 vs. 1.97, p = 0.093; at 3 hour: 1.08 vs. 1.31, p = 0.183; and at 4 hour: 0.69 vs. 0.85, p = 0.169; respectively). There were no side effects and no significant differences in overall patient satisfaction between the two groups.


CONCLUSIONS
Ibuprofen was consistently better than acetaminophen at 1 hour after treatment for relief of perineal pain after childbirth without any side effects. After 2 hours, ibuprofen and acetaminophen had similar analgesic properties.
Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Rungtiwa
R
Kamondetdecha
Yuen
Y
Tannirandorn
D000082:Acetaminophen / Q000627:therapeutic use*; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D004841:Episiotomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use*; D009437:Neuralgia / Q000188:drug therapy*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction; D011247:Pregnancy; D013997:Time Factors
D018712:Analgesics, Non-Narcotic; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen; D007052:Ibuprofen