Comparative Study Between Intravenous Paracetamol and Intramuscular Tramadol as Intrapartum Labor Analgesics in Primigravida (Code-T0243)

Background: Effective pain management during labor is essential for the well-being of both the mother and fetus. Various analgesics are available, with intravenous paracetamol and intramuscular tramadol being two commonly used options. However, there is limited data comparing the efficacy and safety of these two drugs during labor, especially in primigravida (first-time mothers).

Aim and Objective:

• To compare the role of intravenous paracetamol vs intramuscular tramadol as an intrapartum labor analgesic.
• Primary objective – To measure the pain using Mc Gills pain intensity scale in both the groups before of drug , 1 hour and 3 hours after administration of respective drugs .
• Secondary objective - To analyze the mode of delivery , duration of labor, drug delivery interval , maternal side effects and APGAR scores and NICU admissions .

Methods: A randomized controlled trial was conducted involving 100 primigravida women who were in active labor. Participants were randomly assigned to receive either intravenous paracetamol (1g) or intramuscular tramadol (50mg). Pain intensity was measured using the visual analog scale (VAS) at multiple time points during labor. Maternal satisfaction, side effects, and delivery outcomes were also recorded.

Results: Both analgesics significantly reduced pain scores, with no statistically significant difference between the two groups in terms of pain relief. However, maternal satisfaction was higher in the intravenous paracetamol group. Side effects such as nausea and dizziness were more common in the tramadol group. The duration of labor and neonatal outcomes did not differ significantly between the two groups.

Conclusion: Intravenous paracetamol and intramuscular tramadol are both effective for pain relief during labor in primigravida. However, intravenous paracetamol may offer better maternal satisfaction with fewer side effects, making it a preferable option for intrapartum analgesia.

Keywords: Intrapartum analgesia, Intravenous paracetamol, Intramuscular tramadol, Primigravida, Pain relief, Maternal satisfaction.