A comparative study of intrapartum epidural analgesia with intramuscular tramadol on labor outcome
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20240790Keywords:
Labor, Epidural analgesia, Intramuscular tramadolAbstract
Background: Epidural analgesia produces analgesia in labour without affecting nervous system, allows the mother to be well oriented, fully conscious and alert throughout labour. The aim of this study is to study the effect of epidural analgesia and intramuscular (IM) tramadol in different stages of labour and compare the effect of epidural analgesia with intramuscular tramadol on progress of labour and its outcome.
Methods: Continuous monitoring of the haemodynamic parameters of the mother was done using multiparameter monitors. Foetal monitoring was done using continuous cardiotocography (CTG) monitor. Primigravida in spontaneous labour were randomly divided into two groups. Group I received epidural analgesia and group II received IM tramadol.
Results: Duration of Ist stage of labour in group I was 167.0±47.2 min and in group II was 214.4±50.2 min. Mean duration of III stage of labour in the present group I was 7.9 min and 7.5 min in the group II. In the present study, total duration of labour is shortened by 47 min in group I compared to group II.
Conclusions: Epidural analgesia during labour is a simple and effective method for painless and safe delivery. Analgesia produced by epidural route is significantly more effective than intramuscular tramadol. Epidural analgesia has favourable effect on the progress of labour. In developing nations where availability of facilities is the main limiting factor, intramuscular tramadol which is a safe and satisfactory drug for relief of labour pain, can be considered as a suitable alternative.
References
Rudra A. Pain relief in labour. Update in Anaesthesia. 2004;18(3):6-11.
Arulkumaran SS, Rathnam SS, Bhaskar Rao K. Management of labour. 2nd edition. Chapter 3. Orient Longman Publication. 2004;53-6.
Jain S, Agra V, Gopala S, Jain V. Analgesic efficacy of i.m. opioids versus epidural analgesia in labour. Indian J Obstet Gynecol. 2003;83(1):19-27.
Genc M, Sahin N, Maral J, Celik E, Kar AA, Usar P, et al. Does bupivacaine and fentanyl combination for epidural analgesia shorten the duration of labour? J Obstet Gynaecol. 2015;35(7):672-5.
Viegar OAC, Benny Khaw, Ratnam SS. Tramadol in labour pain in primiparous patients – A prospective comparative clinical trial. EJ Obst Gynec Repord Biol. 1993;49:131-5.
Impey L, MacQillan K, Rockson M. Epidural analgesia need not increase operative delivery rates. Am J Obstet Gynaecol. 2000;182(2):358-63.
Lee TSL, Leang T. Pain relief in labour. In: The management of labour. Arulkumaran SS, Rathnam SS, Bhaskar Rao K, editors. 2nd edition. Orient Longman Publication. 2005;53-6.
Lurie S, Matzkel A. Epidural anesthesia shortens of labour in single ton vertex presentasion spontaneous delivery. Asia-Oceania J Obstet Gynaecol. 1991;17:944-50.
Rathna T, Rekha P. Comparative study of transcutaneous electrical nerve stimulation (TENS) and tramadol hydrochloride for pain relief in labour. J Obstet Gynecol India. 2004;54(4):346-50.
Meena J, Singhal P, Choudary D. Programmed labour. IJOG. 2006;56(1):53-5.
Rogers, Rebecca, Gilson, George MD, Kammerer-Doak, Dorthy MD. Epidural analgesia and active management of labour: Effects on length of labour and mode of delivery. Obstetric Gynecol. 1999;93(6):995-8.
Long J, Yue Y. Patient controlled intravenous analgesia with tramadol for labor pain relief. Chin Med J (Engl). 2003;116:1752-5.
Desai P, Patel P, Gupta A. Epidural analgesia in labor. J Obstet Gynaecol India. 2006;56:417-22.
Tripti N, Jyotsna A. Pain relief in labour – Tramadol versus pentazocine. IJOG. 2006;56(5):406-9.
Sarkar B, Mukhopadhyay AK. Tramadol hydrochloride in dysfunctional labour, a clinical trial. J Obstet Gynaecol India. 1997;47(1):42-7.
Meena J, Singhal P, Choudary D. Programmed labour. IJOG. 2006;56(1):53-5.
Rao ZA, Ehsan-Ul-Haq M, Ali L. Evaluation of the analgesic and adverse effects of tramadol in combination with low dose bupivacaine for painless epidural delivery. Pak Armed Forces Med J. 2010;60(3):415-9.
