Impact of Intrapartal Analgesia Using Petihdine or Tramadol on Obstetrical Outcomes – a Head-to-Head Randomized Double Blind Prospective Interventional Study
Dražan Butorac, Ivka Djaković, Ana-Meyra Potkonjak, Krunoslav Kuna, Blaženka Sumpor, Mirjana Radošević Vrkljan, Vesna Košec
Objective: The aim of the study is to compare the effects of tramadol and pethidine during labor on the obstetrical outcomes (their analgesic effect, duration of labor, and the occurrence of adverse events in mother and neonate. Methods: The effect of analgesia was investigated by a prospective head-to-head randomized double-blind intervention study on a sample of 60 women in labor. In the study, 50 mg of tramadol and pethidine was administered intravenously. Data analysis was performed using tests of the difference of two independent proportions and Student’s tests. Prior to the comparison of groups, normality was tested using Kolmogorov-Smirnov test. Results: The use of tramadol is associated with side effects less frequently reported and a shorter labor duration compared to the use of pethidine. Compared to tramadol, a statistically significant lower level of pain was determined after ten minutes and 30 minutes in patients among whom pethidine was used. In the tramadol group, a negative difference in the sensation of pain was determined in both points of measurement that were observed. The effect of tramadol administration vanished after 30 minutes. There were no statistically significant differences in fetal heart rate characteristics, Apgar score, and fetal acid-base status at birth. Conclusion: According to the study, tramadol shortens the duration of labour, whereas pethidine has a stronger analgesic effect, but is also accompanied with more maternal side effects being reported. No difference in the neonatal outcome was found.