Beena Bahuleyan1, Asok Kumar H. S2, Umadevi N3
ABSTRACT: BACKGROUND AND OBJECTIVES: Labor pain is among the severest pains experienced by women. The need for analgesia to overcome pain in labor is highly requested by women today, being the best if facilities are available. But in developing nations IM opioids can be considered. The objective of the study is to compare the effects of intrapartum epidural analgesia with IM Tramadol on progress of labor, maternal and fetal outcome and level of pain relief. METHODS: 120 low-risk Primigravidae attending labor room at IMCH attached to Govt Medical College, Kozhikode during the period of one and half year, from February 2012 to August 2013. Primigravidae were randomly divided into two groups. Group I (60) Administered epidural analgesia at 3-4cm of cervical dilatation. Group II (60) Administered IM Tramadol 100mg at 3-4cm of cervical dilatation. Main outcome measures studied: 1. Duration of active phase of I stage, II stage and III stage. 2. Mode of delivery. 3. APGAR scores. 4. Untoward reactions and intrapartum complications. 5. Overall satisfaction of the mother. RESULTS: Epidural analgesia has shortened the duration of I stage of labour by 45.5min and total duration of labor (by 34min). It has given excellent pain relief and improved neonatal outcome (5min) compared to IM Tramadol. EA is not associated with instrumental vaginal delivery (14% v/s 16%) and LSCS rate (2% v/s 6%). CONCLUSION: EA in labor is highly effective and safe for both mother and the fetus. It has favourable effect on progress of labor, pain relief and neonatal outcome when compared to IM Tramadol. But with limited facilities IM Tramadol can be considered as suitable alternative.
