A thought for tramadol hydrochloride as labor analgesic

To evaluate and compare the analgesic efficacy and adverse effects of tramadol and meperidine in labor.

One hundred sixty-three of the 213 parturients at term in active labor were randomly assigned to one of three groups to receive intramuscularly either tramadol 50 mg (N = 54), tramadol 100 mg (N = 55) or meperidine 75 mg (N = 54). Single person who was not aware of the given drug (NS) assessed analgesic effect using visual analogue scale (VAS). Maternal side effects, effect on labor, and perinatal outcome were also studied.

Effect of the drugs used on maternal and fetal wellbeing was compared within study groups in reference to the control group. The quantitative analysis was done using unpaired t-test and for qualitative analysis chi-square test was applied.

Proportion of cases with satisfactory to good pain relief (VAS difference >5) after 2 h of administration was 35.2 (19 of 54), 61.8 (34 of 55) and 70.3% (38 of 54) in tramadol 50 mg, tramadol 100 mg and meperidine 75 mg groups, respectively. Nausea and/or vomiting (11% vs. 7%), drowsiness (20.4% vs. 5.5%) and fatigue (16.7% vs. 6%) were significantly high in meperidine than in tramadol groups (P<0.05). Proportion of cases with nonreassuring fetal heart rate and neonates with <7 Apgar were high in the meperidine group. Meconium stained liquor was seen equally in tramadol 100 mg and meperidine groups, and was lower in tramadol 50 mg group. All the intervention groups had relatively shorter observed active phase of labor than controls.

Tramadol 100 mg is an equally effective labor analgesic as meperidine with less maternal and perinatal side effects.