Intravenous Infusion of Paracetamol Versus Intravenous Pethidine as an Intrapartum Analgesic in the First Stage of Labor

Elbohoty, Ahmed; Abd-Elrazek, Hiam; Abd-El-Gawad, Magdi; Salama, Fikria; El-Shorbagy, Mahmoud; Abd-El-Maeboud, Karim H. I.

doi:10.1097/01.aoa.0000432386.90054.32

Cited by 4 publications

(5 citation statements)

References 1 publication

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“…On the other hand, Paracetamol when compared to pethidine was found to be better intrapartum labour analgesic. [17,18]. Thus, on the whole concluding that paracetamol has better efficacy than tramadol.…”

Section: Discussionmentioning

confidence: 96%

A Randomized Controlled Trial of Intravenous Paracetamol and Intravenous Tramadol for Labour Analgesia

Garg¹,

Vg²

2019

Obstet Gynecol Res

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Background: Labour pain described as 'the most horrible' affects both physiological and psychological aspects of labour.Thus, the provision of labour analgesia is of paramount importance to better both maternal and neonatal outcomes. In our country, majority of obstetric services are in the hands of trained nurses and non-specialized doctors and thus awareness and acceptance of pain-relieving for women in labour virtually does not exist. Therefore, drugs like paracetamol and tramadol with advantage of easy availability, being inexpensive with no special technique of administration are a boon for labour analgesia.Objective: To compare the role of intravenous paracetamol versus intravenous tramadol as an intrapartum labour analgesic. Materials and methods:A total of 273 primigravidae with term gestation with singleton pregnancy with vertex presentation in active phase of labour with cervical dilatation ≥ 4cm with spontaneous onset of labour were taken who satisfied the inclusion and exclusion criteria of the study. Group P (141 women) and Group T (132 women) received 100 ml intravenous infusion containing 1 gram of paracetamol single dose and 100 mg of tramadol hydrochloride diluted in 100 ml normal saline over 15 minutes respectively. Visual Analogue scale (VAS) was used to assess pain intensity, before administering drug, after 1 and 3 hours of drug administration. The primary outcomes measured were difference in VAS score in both groups. The secondary outcomes analysed were mode of delivery, duration of labour, drug-delivery interval, maternal side effects and neonatal outcomes in terms of birth weight, APGAR scores and NICU admissions. Results:The mean VAS score decreased significantly to a greater extent in group P than group T and showed a significant statistical difference among both the groups (p < 0.001). In both the groups, the difference in the VAS score was statistically significant (p<0.05). The duration of labour was statistically shorter in group P (p< 0.0001). The participants in group T had more incidence of maternal side-effects and 7 NICU admission than in paracetamol group.

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Section: Discussionmentioning

confidence: 96%

A Randomized Controlled Trial of Intravenous Paracetamol and Intravenous Tramadol for Labour Analgesia

Garg¹,

Vg²

2019

Obstet Gynecol Res

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“…Submucous paracervical blockade with bupivacaine provided significantly better pain relief than IM meperidine during labor (39). Two studies comparing parental meperidine with SC or intranasal fentanyl (41) and IV paracetamol (42) showed similar outcomes in labor pain control.…”

Section: Labor Analgesiamentioning

confidence: 97%

Analgesic Efficacy and Adverse Effects of Meperidine in Managing Postoperative or Labor Pain: A Narrative Review of Randomized Controlled Trials

Wong

Cheung

2020

Pain Phys

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Background: Meperidine, a synthetic opioid, has a rapid onset and short duration of action. Mounting evidence has challenged meperidine’s analgesic benefits, and concerns have been raised about its safety profile. Despite recommendations to restrict the prescription of meperidine, the drug remains frequently used. Objectives: The aim of this study was to evaluate the evidence regarding the efficacy and safety of meperidine for acute postoperative and labor pain. Study Design: This was a narrative review of the analgesic efficacy and side effects of meperidine compared to other analgesic drugs for acute postoperative and labor pain in adults. Setting: Randomized controlled trials that compared the analgesic efficacy and side effect profile of meperidine versus another analgesic drug in adult patients were evaluated. Methods: A systemized search of randomized controlled trials studying meperidine for acute postoperative or labor pain in the adult patient population from PubMed, Medline, and EMBASE was performed. Included studies reported on different routes of meperidine administration including intramuscular, intravenous, and patient-controlled analgesia in various surgical procedures such as abdominal surgery, Cesarean section, gynecological surgery, orthopedic surgery, cardiothoracic surgery, as well as for labor analgesia. Meperidine’s analgesic efficacy and safety profile were compared to other opioids (morphine, tramadol, fentanyl, buprenorphine, nalbuphine, and pentazocine), nonsteroidal anti-inflammatory drugs (ketorolac, diclofenac, and indomethacin), dipyrone, ketamine, and bupivacaine. Results: A total of 62 randomized controlled trials published between 1972 and 2018 were reviewed. Meperidine had a similar or inferior analgesic efficacy compared to other analgesics for acute postoperative or labor pain. Meperidine was associated with more sedation and respiratory depression. Limitations: The sample sizes of many clinical studies were small, and therefore probably insufficiently powered to detect differences in uncommon side effects, such as central nervous system toxicity. In addition, some of the included clinical studies were old. Conclusion: Considering the availability of other effective analgesics with potentially fewer side effects, the use of meperidine for acute postoperative or labor pain should not be recommended. Key words: Acute postoperative pain, adverse effects, labor analgesia, meperidine, pethidine

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“…8 Elbohoty et al compared intravenous Paracetamol infusion with intravenous pethidine as labour analgesia. 17 It has been concluded that effectiveness of intravenous Paracetamol and duration of action are similar in each drugs, but Paracetamol was associated with fewer maternal adverse outcomes than pethidine. In a prospective double blind randomized placebo controlled study conducted by Cakan et al on 40 patients undergoing lumbar laminectomy and discectomy, it was demonstrated that IV Paracetamol decreased visual analog scale scores and incidence of vomiting and had better patient satisfaction.…”

Section: Adverse Effectsmentioning

confidence: 99%

Comparison of intravenous paracetamol vs. intramuscular diclofenac for postoperative pain control in abdominal hysterectomy

Bisht

Jain

2021

Int J Reprod Contracept Obstet Gynecol

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Background: Abdominal hysterectomy is one of the most common gynaecological surgery conducted worldwide. It is commonly associated with post operative pain. The aim of this study was Comparison of intravenous Paracetamol versus intramuscular Diclofenac for postoperative pain control in abdominal hysterectomy. Objectives of this study were to compare the effectiveness of intravenous Paracetamol and intramuscular Diclofenac when used for post-operative pain control in abdominal hysterectomy patients and to compare the need for rescue analgesia in both the groups.Methods: It’s a prospective observational and clinically randomized study conducted in Department of Obstetrics and Gynaecology, Government Medical College Haldwani and associated Dr. Shushila Tiwari Government Hospital, Haldwani consisting of 120 patients undergoing abdominal hysterectomy. 60 patients in group A received Paracetamol 1000 mg (100ml infusion) intravenous followed by subsequent doses of 1000 mg every 8 hourly for 48 hrs and another 60 patients in group B received injection Diclofenac 75 mg intramuscular every 8 hourly for 48hrs. Pain intensity of patients was noted 2 hourly for 6 hours after giving the first dose of the drug and then at every 8 hour for next 48 hours, using VAS scoring. Patient’s hemodynamics in form of respiratory rate, heart rate, mean arterial pressure (MAP), oxygen saturation (sPO2) were monitored as per pain monitoring protocol.Results: Post-op mean VAS score at different point of time among the two treatment groups was lower for Paracetamol group as compared to Diclofenac group. The difference was found to be statistically significant at all point of time post op. Adverse effect like nausea, vomiting and dizziness was seen more among Diclofenac group as compared to Paracetamol group.Conclusions: Intravenous Paracetamol use was found to be associated with better postoperative pain relief and reduced need for rescue analgesia consumption in the postoperative period.

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Intravenous Infusion of Paracetamol Versus Intravenous Pethidine as an Intrapartum Analgesic in the First Stage of Labor

Cited by 4 publications

References 1 publication

A Randomized Controlled Trial of Intravenous Paracetamol and Intravenous Tramadol for Labour Analgesia

A Randomized Controlled Trial of Intravenous Paracetamol and Intravenous Tramadol for Labour Analgesia

Analgesic Efficacy and Adverse Effects of Meperidine in Managing Postoperative or Labor Pain: A Narrative Review of Randomized Controlled Trials

Comparison of intravenous paracetamol vs. intramuscular diclofenac for postoperative pain control in abdominal hysterectomy

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