Abdollahi Mohammad-Hasan, Mojibian Mahdiye, Pishgahi Alireza, Mallah Fatemeh, Dareshiri Shahla, Mohammadi Sahar, Naghavi-Behzad Mohammad
Department of Anesthesia, Shahid Sadoghi University of Medical Science, Yazd, Iran.
Department of Gynecology and Obstetrics, Shahid Sadoghi University of Medical Science, Yazd, Iran.
Niger Med J. 2014 Jan;55(1):54-7. doi: 10.4103/0300-1652.128167.
Intramuscular pethidine is one of most common opioids used for labour analgesia. There are a number of concerns in the literature regarding the use of pethidine. The aim of this study is to compare analgesic efficacy of paracetamol with pethidine for labour pain in normal vaginal delivery.
In this single-blinded, randomised control trial, 80 primigravid singleton women with full-term pregnancy candidate for normal vaginal delivery, were entered the trial and divided in to pethidine (A) and paracetamol (B) groups. At the time of admission, age and body mass index of mother and gestational age based on last day of period were recorded. In both groups, intravenous promethazine and hyoscine were administered to each patient at the first stage of delivery. From beginning of active phase of delivery, patients in group A received 50 mg intramuscular pethidine injection. At the same time patients in group B, received an intravenous solution infusion containing 1000 mg paracetamol and 300 cc of normal saline. After child birth, average labour pain was assessed using Visual Analogue Scale (VAS) by direct questioning from patient in both groups.
After patients' selection, 19 individual omitted during study due to exclusion criteria and finally 30 patients in paracetamol group and 31 patients in pethidine group remained to enter the trial. There was no significant difference in age and BMI of mothers between both groups (P > 0.05). Maternal age and labour duration in paracetamol group had no meaningful difference with maternal age and labour duration of patients in pethidine group (P > 0.05). The average VAS pain score was significantly lower in paracetamol comparing to that of pethidine group (8.366 out of 10, 9.612 out of 10, respectively, P < 0.001).
It is concluded that intravenous paracetamol is more effective than intramuscular pethidine to relief labour pain in normal vaginal delivery.
肌内注射哌替啶是分娩镇痛最常用的阿片类药物之一。文献中对哌替啶的使用存在诸多担忧。本研究的目的是比较对乙酰氨基酚与哌替啶对正常阴道分娩时产痛的镇痛效果。
在这项单盲随机对照试验中，80名足月妊娠、计划进行正常阴道分娩的初产妇进入试验，并分为哌替啶组（A组）和对乙酰氨基酚组（B组）。入院时，记录产妇的年龄、体重指数以及基于末次月经日期的孕周。两组患者在分娩第一阶段均静脉注射异丙嗪和东莨菪碱。从分娩活跃期开始，A组患者接受50mg哌替啶肌内注射。同时，B组患者接受含1000mg对乙酰氨基酚和300cc生理盐水的静脉输液。分娩后，通过直接询问两组患者，使用视觉模拟评分法（VAS）评估平均产痛。
患者入选后，19人因排除标准在研究期间被剔除，最终对乙酰氨基酚组30名患者和哌替啶组31名患者进入试验。两组产妇的年龄和体重指数无显著差异（P>0.05）。对乙酰氨基酚组产妇年龄和产程与哌替啶组患者的产妇年龄和产程无显著差异（P>0.05）。对乙酰氨基酚组的平均VAS疼痛评分显著低于哌替啶组（分别为10分制中的8.366分和9.612分，P<0.001）。
得出结论，静脉注射对乙酰氨基酚在缓解正常阴道分娩产痛方面比肌内注射哌替啶更有效。
