Tramadol: For Pain Management in Labor

Effective pain management during labor is a crucial aspect of quality obstetric care. Although the intense pain experienced during labor is not life-threatening, it can have physiological and neuropsychological consequences. Providing adequate analgesia during labor benefits the mother and positively influences the progress of labor and the well-being of the newborn. Thus, an ideal obstetric analgesic should possess potent opiate-like efficacy with minimal side effects. Tramadol, due to its characteristics, can serve as a fundamental analgesic for treating patients with moderate to severe pain during labor. The administration of parenteral tramadol during labor has been proven to have no adverse effects on either the baby or the labor process.

The goal of a recent study conducted in the Department of Obstetrics and Gynecology, Gandhi Medical College and Hospital, Hyderabad, was to study the efficacy of Intramuscular tramadol hydrochloride on Primigravida and Multigravida – in terms of pain alleviation during labor; to study the drug effects on the labor duration; and the drug effects on the mother and the baby. This study was conducted over one year – 2022-23 and included 500 participants aged 18-35 years. The participants were divided into control and study groups, each comprising 250 participants.

The results revealed a significant reduction in pain levels compared to the control group following Intramuscular Tramadol injection. Additionally, most patients in the study group experienced positive neonatal outcomes, with no maternal complications and a shortened labor duration. In the study group, 10% and 43.2% of patients had Grade III and Grade IV pain, respectively. In contrast, in the control group, 13.2% and 54.4% had Grade III and Grade IV pain – indicating statistical significance.

Therefore, intramuscular Tramadol Injection is safe for both mother and baby, effective in alleviating pain, and contributes to the reduction of labor duration. It offers the expecting woman the pleasure of a typical delivery with significantly reduced labor pains. Tramadol hydrochloride effectively manages first-stage labor pain, shortening the time between the first and second stages without affecting the duration of the third stage. Furthermore, instrumental or cesarean section rates significantly decreased with Tramadol injection, and no adverse effects were observed on the mother or the fetus. Tramadol did not lengthen hospital stays or increase maternal morbidity, making it a cost-effective labor pain management modality.

Source: Vellanki J, Sri V S. Indian J Obstet Gynecol Res. 2023;10(4):387-392