Comparison of Intravenous Paracetamol Infusion Versus Intramuscular Tramadol as an Intrapartum Analgesic

Abstract

Objective: To compare the mean intrapartum pain score between intravenous paracetamol infusion and intramuscular tramadol.

Methodology: This randomized controlled trial was conducted at the Department of Obstetrics and Gynecology, Indus Hospital, Muzaffargarh, from August 2023 to February 2024, included women with full-term pregnancy, aged 20–40 years, carrying a single fetus, and having a spontaneous onset of labor in the active phase. Participants were equally divided into two groups: Group A received intravenous paracetamol, while Group B received intramuscular tramadol. Pain scores were recorded before drug administration and at 1 and 3 hours post-administration. The mode of delivery and duration of labor were also documented.

Results: The mean age of the participants was 27.7 ± 4.2 years. The mean duration of labor was significantly shorter in the paracetamol group (4.6 ± 0.8 hours) compared to the tramadol group (5.9 ± 0.8 hours) (p = 0.001). Furthermore, the mean pain score at three hours after treatment was significantly lower in the paracetamol group compared to the tramadol group (mean VAS = 6.8 ± 0.8 vs. 7.8 ± 0.7, respectively) (p = 0.001).

Conclusion: Intravenous paracetamol was found to be more effective in providing labor analgesia and in reducing the duration of labor compared to intramuscular tramadol. Additionally, it is an easy, affordable, and practical option for use in low-resource settings where access to advanced healthcare facilities is limited.