Intravenous Paracetamol as a Safe and Effective Alternative to Intramuscular Tramadol for Labour Analgesia in Low-Resource Settings: A Randomised Controlled Study

Intravenous Paracetamol as a Safe and Effective Alternative to Intramuscular Tramadol for Labour Analgesia in Low-Resource Settings: A Randomised Controlled Study | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 2 June 2025 V1 Latest version Share on Intravenous Paracetamol as a Safe and Effective Alternative to Intramuscular Tramadol for Labour Analgesia in Low-Resource Settings: A Randomised Controlled Study Authors : Rana Mondal 0000-0001-9826-1775 [email protected] , Mouli Nandi , and Ifra Iqbal Authors Info & Affiliations https://doi.org/10.22541/au.174886207.74586327/v1 269 views 160 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Abstract Objective To compare the efficacy and safety of intravenous paracetamol with intramuscular tramadol hydrochloride as intrapartum analgesia in primigravida women during the active phase of labour. Design Prospective, single-blind, randomised controlled trial. Setting Labour ward of a tertiary care hospital in India. Population or Sample Primigravida women aged 18–30 years with term, singleton, vertex pregnancies in spontaneous active labour, meeting strict inclusion criteria. Methods A total of 9,945 women were randomised into two groups: Group 1 received 1000 mg intravenous paracetamol; Group 2 received 100 mg intramuscular tramadol. Pain was measured using the Visual Analogue Scale (VAS) at baseline, 10 minutes, and one hour post-intervention. Labour outcomes, maternal side effects, and neonatal parameters were recorded and analysed. Main Outcome Measures Reduction in VAS pain scores, duration and mode of delivery, maternal side effects, Apgar scores, neonatal respiratory status, and NICU admissions. Results Both medications effectively reduced labour pain. At one hour, the tramadol group showed significantly greater pain relief (VAS 4.70 ± 0.86 vs. 5.02 ± 0.78; p = 0.0063). However, the paracetamol group experienced fewer side effects, including significantly less vomiting (10% vs. 23%; p = 0.0222), and had better neonatal outcomes. Apgar scores at 1 and 5 minutes were significantly higher in the paracetamol group ( p = 0.0001 and p < 0.0001), with fewer cases of neonatal respiratory depression. Conclusions Intravenous paracetamol is a safe, effective, and accessible alternative to tramadol for labour analgesia, especially suited to low-resource settings due to its ease of use and favourable safety profile. Funding No funding was received for this study. Trial Registration Clinical Trials Registry – India (CTRI/2018/06/014589) Keywords Paracetamol, Tramadol, Labour analgesia, Intrapartum pain, Randomised controlled trial, Low-resource settings Supplementary Material File (efficacy and safety of intravenous paracetamol versus intramuscular tramadol hydrochloride as intrapartum analgesic a randomised controlled study.docx) Download 110.40 KB Information & Authors Information Version history V1 Version 1 02 June 2025 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords analgesia: obstetric developing countries: obstetrics and gynaecology health economists health services research intrapartum care maternity services randomised controlled trials Authors Affiliations Rana Mondal 0000-0001-9826-1775 [email protected] Bansal Hospital View all articles by this author Mouli Nandi Luton and Dunstable University Hospital Centre of Multi-professional Education and Training View all articles by this author Ifra Iqbal Apollo Gleneagles Nursing College View all articles by this author Metrics & Citations Metrics Article Usage 269 views 160 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Rana Mondal, Mouli Nandi, Ifra Iqbal. Intravenous Paracetamol as a Safe and Effective Alternative to Intramuscular Tramadol for Labour Analgesia in Low-Resource Settings: A Randomised Controlled Study. Authorea . 02 June 2025. DOI: https://doi.org/10.22541/au.174886207.74586327/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . Format Please select one from the list RIS (ProCite, Reference Manager) EndNote BibTex Medlars RefWorks Direct import Tips for downloading citations document.getElementById('citMgrHelpLink').addEventListener('click', function() { popupHelp(this.href); return false; }); $(".js__slcInclude").on("change", function(e){ if ($(this).val() == 'refworks') $('#direct').prop("checked", false); $('#direct').prop("disabled", ($(this).val() == 'refworks')); }); View Options View options PDF View PDF Figures Tables Media Share Share Share article link Copy Link Copied! Copying failed. 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