Intravenous infusion of paracetamol for intrapartum analgesia

Abd-El-Maeboud, Karim H. I.; Elbohoty, Ahmed; Mohammed, Walid E.; Elgamel, Hatem M.; Ali, Walid A. H.

doi:10.1111/jog.12465

Cited by 16 publications

(14 citation statements)

References 30 publications

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“…Foetal bradycardia being 15% in both the groups was also comparable. These data confirm the finding of the two previous trials by Elbohoty and colleagues 9 and Abd-El-Maeboud and colleagues, 10 who demonstrated no differences in occurrence of intrapartum foetal distress or neonatal Apgar scores in patients receiving paracetamol. The recent Cochrane meta-analysis, too reports no adverse neonatal outcome in labour epidural deliveries.…”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

I.V. paracetamol as an adjunct to patient-controlled epidural analgesia with levobupivacaine and fentanyl in labour: a randomized controlled study

Gupta

Mitra

Kazal

et al. 2016

British Journal of Anaesthesia

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Section: Discussionsupporting

confidence: 91%

“…paracetamol during intrapartum period. [9][10][11][12][13][14][15][16][17][18] Elbohoty and colleagues 9 showed that use of i.v. paracetamol, was as effective as pethidine for intrapartum analgesia during the first stage of labour.…”

Section: Discussionmentioning

confidence: 99%

I.V. paracetamol as an adjunct to patient-controlled epidural analgesia with levobupivacaine and fentanyl in labour: a randomized controlled study

Gupta

Mitra

Kazal

et al. 2016

British Journal of Anaesthesia

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“…In triple-blind randomized trial on 120 primiparous women, randomized into receiving either 1000 mg of paracetamol infusion, meperidine (50 mg), or placebo, there were significantly lower pain scores 15 and 30 min after administration of the medication. 14 Similarly, in a recent randomized trial on 38 women by Ankumah and colleagues, the pain scores were comparable in both groups of women up to 120 min after administration of the analgesic. 15 Regarding the maternal adverse effects, the administration of meperidine was associated with a 12fold risk of dizziness and nausea/vomiting compared to paracetamol.…”

Section: Discussionmentioning

confidence: 80%

“…13 The major concerns are associated with the use of opioid analgesia are the risk of fetal/neonatal respiratory depression, and the cost and availability. 14 Therefore, there is a call to find a readily-available, lowcost and quite safe analgesic for labor pain relief.…”

Section: Discussionmentioning

confidence: 99%

Paracetamol versus meperidine for relief of labour pain in primiparous women: a randomized controlled trial

Habib¹,

Mostafa²,

Salama³

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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Background: Most parturient women request analgesia, of which, there are two types; opioids and non-opioids. Opioids include morphine and meperidine, while non-opioids, which are milder forms of painkillers, include acetaminophen (paracetamol) and non-steroid anti-inflammatory drugs. The major concerns associated with opioids are the risk of neonatal respiratory depression, the cost and availability.Methods: The aim of this study was to compare the efficacy and safety of paracetamol versus meperidine for intra-partum pain relief. A total of 92 primiparous singleton term pregnant women were randomly allocated to receive intravenous paracetamol (1000 mg), or intramuscular meperidine (50 mg), at the beginning of the active phase of labor. The primary outcome was the labor pain perception, assessed using the visual analogue scale (VAS), at baseline, 15, 30, 60 and 120 minutes after administration of the drug.Results: Women of both groups showed significant reduction of the VAS after administration of the medication. There were no differences between both groups regarding the mode of delivery and the durations of the first or second stages of labor. However, meperidine was associated with higher rates of dizziness and nausea/vomiting. The 1-min Apgar scores were significantly lower in meperidine group. However, there were no differences in the 5-min Apgar score, need for neonatal resuscitation or neonatal respiratory distress.Conclusions: intravenous paracetamol as analgesia during labor is effective with no fetal or maternal adverse effects. Its use should have more chance for intrapartum pain relief. Additionally, it can be used as adjuvant with other types of analgesics.

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“…The sample size was calculated using Stata version 10 (StataCorp LP, College Station, Texas, USA), setting power of the study (1-β) at 90% and type-1 error (α) at 0.01. Data from a relevant study with similar prospect (9) indicated that the failure rate (use of rescue analgesic) was 14% in the study group after 1 h of receiving paracetamol.…”

Section: Statistics Sample Sizementioning

confidence: 91%

Efficacy of Intravenous Tenoxicam as an Analgesic during the First Stage of Labor : A Randomized Controlled Trial

Shalaby¹,

Hemada²,

Faris³

2018

Egyptian Journal of Hospital Medicine

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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.

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Intravenous infusion of paracetamol for intrapartum analgesia

Abstract: Paracetamol appears to be a safe and effective medicine that can be used during the intrapartum period.

Cited by 16 publications

References 30 publications

I.V. paracetamol as an adjunct to patient-controlled epidural analgesia with levobupivacaine and fentanyl in labour: a randomized controlled study

I.V. paracetamol as an adjunct to patient-controlled epidural analgesia with levobupivacaine and fentanyl in labour: a randomized controlled study

Paracetamol versus meperidine for relief of labour pain in primiparous women: a randomized controlled trial

Efficacy of Intravenous Tenoxicam as an Analgesic during the First Stage of Labor : A Randomized Controlled Trial

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