Comparison of Pain Score and Complications Following Acetaminophen and Pethidine Injection During Vaginal Delivery: A Double-blind Clinical Trial

Oman Med J. 2021 Mar 31;36(2):e250. doi: 10.5001/omj.2021.58. eCollection 2021 Mar.

Abstract

Objectives: Recently, intravenous acetaminophen has been introduced as an intervention with analgesic potential similar to that of opioid analgesics in labor pain management. This study aimed to compare the pain score and maternal and neonatal complications following acetaminophen and pethidine injections during vaginal delivery.

Methods: This randomized, double-blind clinical trial was conducted on pregnant women during the first stage of delivery referred to Ghaem and Omolbanin Hospitals in Mashhad, Iran, from March to December 2017. The subjects were assigned randomly to one of two groups: acetaminophen and pethidine. The pain intensity was measured before and 15, 60, 120, 180, and 240 minutes after injection.

Results: The pain score and pain score changes showed no significant difference between the two groups at different times. The incidence of maternal complications during delivery and the first hour after delivery was not statistically significant between the two groups, but 15 minutes after injection, vomiting (p = 0.001), nausea (p = 0.001), and dizziness (p = 0.001) were significantly higher in the pethidine group. The mean one and five minutes Apgar scores were significantly higher in the acetaminophen group.

Conclusions: Intravenous acetaminophen led to fewer maternal complications than pethidine, especially during the first 15 minutes after injection and fewer neonatal complications, especially in the Apgar score.

Keywords: Acetaminophen; Analgesics, Opioid; Apgar Score; Delivery, Obstetric; Infant, Newborn; Labor Pain; Pain Management; Pregnancy.