Dharmavijaya M. N.1 , Pallavi
BACKGROUND Pain during labour is the most severe pain experienced by women in labour. The need for labour analgesia to overcome the labour pain is highly requested by women today. Intramuscular opioids can be considered in developing nations where availability of facilities is the main limiting factor. We wanted to evaluate the efficacy of intramuscular tramadol hydrochloride as a labour analgesic and labour accelerator by calculating pain relief scores in labour, the duration of labour and the effect of the drug on both mother and new born. METHODS The study was conducted in MVJ Medical College and Research Hospital, Bangalore. The selection criteria for primigravida was full-term pregnancy with good uterine contractions with vertex presentation and in active phase of labour. 50 selected primigravida were given intramuscular 50 mg tramadol hydrochloride and were compared with 50 cases without tramadol. After administration of tramadol in active stage of labour, degree of pain relief, injection delivery time, Apgar score of neonates and side effect of the drug were studied. RESULTS Before administration of the drug to 50 selected primigravida, there were no patients who had grade I or grade II pain. 30% had grade III pain and 70% had grade IV pain. There was reduction in pain from grade IV and grade III after administration of tramadol hydrochloride IM and all patients continued with grade II pain and delivered vaginally. Minimal side effects like nausea and vomiting were observed only in 4 women but in the other group i.e., without tramadol administration, there was no reduction of pain. CONCLUSIONS Tramadol hydrochloride administration IM appears to be effective in low risk primigravida with minimal side effects. Hence, IM opioids can be considered as suitable alternatives in developing nations, where availability of facilities is the main limiting factor.
