No abstract

Background: childbirth is one of the most painful events of a woman's life. The experience of labor pain is a complex, multidimensional response to sensory stimuli generated during parturition and its intensity can vary greatly. Unlike other acute and chronic pain experiences, labor pain is not associated with pathology, but with the most basic and fundamental of life's experiences Aim of the work: this work aimed to study the efficacy of intravenous tenoxicam for labor analgesia. Patient and methods: this was two-arm, randomized controlled trial. The first arm (Group T) represented subjects who received tenoxicam. The second arm (Group R) represented subjects who received routine analgesic pethidine and it is given at a dose of 50 mg diluted over 10 ml of normal saline. The parturient woman was given 3-4 cm of diluted pethidine whenever she has intolerable pain. Results: this study included 260 subjects that were allocated into two arms: tenoxicam arm (n=118) and pethidine arm (n=142) as the control group. Tenoxicam group included 118 subjects and the pethidine group included 142 subjects. Maternal age was 23.74 ± 3.76 in tenoxicam group vs 23.99 ± 3.5 in pethidine group. Gestational age was 39.04 ± 1.42 in tenoxicam group vs 38.93 ± 1.5 in pethidine group. Birth weight was 3.43 ± 0.26 in tenoxicam arm vs 3.41 ± 0.26 in pethidine arm, average fetal heart rate was 140.1 ± 17.12 in tenoxicam arm vs 138.1 ± 16.39 pethidine arm, cervical dilatation was 4.19 ± 0.77 in tenoxicam arm vs 4.25 ± 0.7 and interval to delivery was 5.89 ± 1.29 in tenoxicam arm vs 6.2 ± 1.62 in pethidine arm. Conclusion: tenoxicam (40 mg iv), a long acting NSAID that induces analgesia by inhibiting peripheral prostaglandin synthesis, reduced postpartum uterine contraction pain without apparent maternal or neonatal adverse effects. Furthermore, tenoxicam exhibits superior analgesic properties over the routinely used pethidine as labor analgesic. Further studies should evaluate analgesic effects vs side effects of iv tenoxicam as a function of dosage or as part of combination therapy with different opioid analgesics.