title: Comparison of analgesic efficacy of paracetamol and tramadol for pain relief in active labor.
abstract: OBJECTIVE
  To evaluate the efficacy and safety profile of paracetamol in comparison with tramadol for pain relief during active labor.
  
  
  METHODS
  Prospective, randomized, double-blind study.
  
  
  METHODS
  Maternity Wing of the Postgraduate Institute of Medical Education and Research, Chandigarh.
  
  
  METHODS
  Sixty laboring, primiparous, full-term parturients with uncomplicated, singleton pregnancy in spontaneous labor and cervical dilatation of 3-5 cm.
  
  
  METHODS
  Parturients were randomized into 2 groups to receive either 1 mg/kg of tramadol intramuscularly (group T; n = 29) or 1 g of paracetamol intravenously (group P; n = 30). Same doses of the drugs were repeated after 4 hours of initial dose.
  
  
  METHODS
  Primary outcome of the study was to assess the analgesic efficacy of the 2 drugs as measured by visual analog scale (VAS) score. Secondary outcome recorded was duration of labor, presence of any maternal, or fetal adverse events during the study.
  
  
  RESULTS
  Both the groups showed comparable VAS scores at all times of observation. Lower mean VAS scores were reported in both the groups till 120 minutes only. The duration of first stage of labor was shorter in group P (248.00 ± 98.171 vs 340.63 ± 111.592 minutes; P = .003). The duration of second stage of labor was comparable between the 2 groups. Higher incidence of maternal side effects such as nausea/vomiting and sedation was associated with the use of tramadol. Neonatal outcome was comparable.
  
  
  CONCLUSIONS
  Intravenous paracetamol provides comparable analgesia as intramuscular tramadol during active labor.
authors.affiliation: Department of Anesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: jeet1516@gmail.com.
authors.forename: Jeetinder
authors.initials: J
authors.lastname: Kaur Makkar
authors.affiliation: Department of Anesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: kajalteji@gmail.com.
authors.forename: Kajal
authors.initials: K
authors.lastname: Jain
authors.affiliation: Department of Anesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: nidhi.bhatia75@gmail.com.
authors.forename: Nidhi
authors.initials: N
authors.lastname: Bhatia
authors.affiliation: Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: drvanitajain@yahoo.com.
authors.forename: Vanita
authors.initials: V
authors.lastname: Jain
authors.affiliation: Department of Anesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: drsamsumit12@gmail.com.
authors.forename: Sanwar
authors.initials: S
authors.lastname: Mal Mithrawal
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D016362:Analgesia, Obstetrical / Q000009:adverse effects / Q000379:methods*; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage* / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007273:Injections, Intramuscular; D007743:Labor, Obstetric; D010146:Pain / Q000517:prevention & control; D010147:Pain Measurement / Q000379:methods; D011247:Pregnancy; D011446:Prospective Studies; D014147:Tramadol / Q000008:administration & dosage* / Q000009:adverse effects; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000082:Acetaminophen; D014147:Tramadol
keywords: Active labor; Analgesia; Paracetamol; Side effects; Tramadol