Sundus Yousif Kellow
Shlear Majeed Muhammad Ali
University of Sulaimani, Faculty of Medical SciencesSchool of Medicine, Department of Obstetrics & Gynecology
Maternity Teaching Hospital, Sulaimani Directorate of Health, Sulaimani.
EFFECT OF PETHIDINE VERSUS TRAMADOL ON LABOUR PAIN IN PRIMIPAROUS WOMEN
Labour has long been recognized as a very painful event. Meperidine or Pethidine is one of the most frequently used opiate agonists while Tramadol is a centrally acting analgesic. There are variable debates about their uses in labour and their effects on progress of labour, mother and her fetus.
To evaluate and compare the efficacy and adverse effects of intramuscular Pethidine versus Tramadol as an analgesic during labour.
Patients and Methods
A randomized controlled prospective study carried at Sulaimani Maternity Teaching Hospital throughout the period 1st of January to 1st of July 2010. Two hundred twenty five full terms parturient, were randomly assigned into: Group 1, included 75 cases received 100 mg Pethidine intramuscularly; group 2, included 75 cases received 100 mg Tramadol intramuscularly; and group 3, included 75 cases received 1ml distilled water intramuscularly as control group. Analgesic efficacy, maternal and neonatal side effects, duration of labour and maternal satisfaction were determined.
Following drug administration, significant reduction in pain level achieved after 60 and 120min in the studied groups. Maternal side effects such as nausea, vomiting, drowsiness, and dry mouth occurred more frequently in Pethidine group than the others (p-value < 0.05). Both drugs caused shortening in the duration of active phase of 1st stage of labour. Regarding the neonatal outcome, infants of Pethidine group showed poorer feeding, poor reflex and drowsiness, but non of the neonates developed respiratory depression.
Pethidine seem to be better than Tramadol as obstetric analgesia because of its superiority in pain relief but with more side effects on the mother and her baby.
Keywords: Labour, Pethidine, Tramado, Aanalgesia, Dduration of labour.