Intravenous paracetamol infusion versus intramuscular tramadol as an intrapartum analgesic

Aim: To compare intravenous Paracetamol and intramuscular tramadol as labour analgesia and to evaluate the incidence of side effects on mother and fetus of both the drugs. Material and methods: It was a prospective, observational and clinically randomized study conducted in the labor room of the dept of Obstetrics and Gynaecology/Govt. medical college Rajindra hospital, Patiala, Punjab. A total of 200 pregnant women were included in study after fulfilling inclusion criteria. these women were divided into 2 groups of 100 each Group A: received a 100ml intravenous infusion containing 1000mg paracetamol single dose over 15min. Group B: received intramuscular tramadol hydrochloride 100mg single dose. Pain intensity of women with both drugs was noted before administration of drug, one hour and three hours after administration of drug using Mc Gills Pain intensity scale.Result: No difference in pain intensity is seen before drug administration. After 1 h of drug administration, in paracetamol group, 6.3% women had horrible pain, and 29.5 % had distressing pain, while in tramadol group, 28.6 % women had horrible pain, and 57.1 % had distressing pain. After 3 h of drug administration, in paracetamol group, 23.2 % had distressing pain, while in tramadol group, 46.9 % women had horrible pain, and 32.7 % had distressing pain. Labor duration in paracetamol and tramadol group was 5.2 and 5.6 h, respectively. In paracetamol group, nausea is seen in 6 % and vomiting in 3 %, while in tramadol group, nausea is seen in 8 % and vomiting in 7 %. Conclusions: Intravenous paracetamol is more effective labour analgesic with fewer maternal adverse effects and shortens labour as compared to intramuscular tramadol.