Intravenous infusion of paracetamol versus intravenous pethidine as an intrapartum analgesic in the first stage of labor

Objective To evaluate the efficacy and adverse effects of an intravenous infusion of 1000 mg of paracetamol as compared with an intravenous injection of 50 mg of pethidine hydrochloride for intrapartum analgesia. Methods In a randomized prospective study at Ain Shams University, Cairo, Egypt, between April and August 2010, 102 low-risk primiparous women in active labor were allocated to received either paracetamol (n = 52) or pethidine hydrochloride (n = 50). The primary outcome was the efficacy of the drug to supply adequate analgesia as measured by a change in the visual analog scale (VAS) pain intensity score at various times after drug administration. The secondary outcomes included the need for additional rescue analgesia and the presence of adverse maternal or fetal events. Results As recorded by the VAS score, there was significant pain reduction at 15 minutes, and at 1 and 2 hours in both groups (P < 0.001). The reduction in pain was significantly greater in the pethidine group only at 15 minutes (P = 0.004). None of the women in the paracetamol group had adverse effects, as compared with 64% of the women receiving pethidine. Conclusion The effectiveness of intravenous paracetamol was comparable to that of intravenous pethidine, but paracetamol had fewer maternal adverse effects.