Intravenous Paracetamol Vs. Intravenous Tramadol for Labor Analgesia

Labor pain ranks among the most agonizing experiences for women. The use of pain relief measures during labor is crucial not only to alleviate maternal distress but also to enhance both maternal and perinatal outcomes. Due to their availability, affordability, and ease of administration, paracetamol and tramadol present practical options for pain management during childbirth.

A recent study compared the efficacy of intravenous paracetamol and intravenous tramadol for labor analgesia. It included 130 patients divided into two groups, where Group A received 1000 mg of intravenous paracetamol and Group B received 100 mg of intravenous tramadol hydrochloride for labor analgesia in the active phase of labor (>/= 4 cm cervical dilatation).

 The study assessed Pain intensity by Visual Analogue scale (VAS) before, after 1 and 3 hours of drug administration. It also evaluated the duration of labor, mode of delivery, drug-delivery interval, maternal side effects, and neonatal outcomes.

The study observed-

• Inclusion of 130 patients, with 65 in each group. 
• Significantly lower mean VAS score after 1 and 3 hours of drug administration in Group A than in Group B. 
• The significantly lower mean duration of 1 stage of labor (210.79±70.49 minutes) and mean drug delivery interval (4.34 hours) in Group A than in Group B (246.95+/-76.09 minutes; 5.17 hours). 
• More maternal side effects with tramadol than with paracetamol.

This study proves intravenous paracetamol is effective labor analgesia with a lesser VAS score, shorter duration of labor, drug delivery interval, and few maternal side effects.

Marwah M, Mandrelle K, Liddle D, A randomized controlled trial of intravenous paracetamol and intravenous tramadol for labor analgesia. Indian J ObstetGynecol Res. 2023;10(3):259-265