TO STUDY EFFECTIVENESS OF DIFFERENT ANALGESIC DRUGS FOR LABOUR ANALGESIA IN OBSTETRICS AND GYNAECOLOGY DEPARTMENT OF TERTIARY CARE HOSPITAL
Main Article Content
Keywords
Analgesic drugs, Labour, Analgesia, Labour pain, Pregnant women, VAS score
Abstract
Introduction:
Labour pain is considered one of the most intense types of pain, necessitating effective pain management techniques to ensure maternal comfort and safety. Various analgesic drugs are available, but their efficacy can vary, particularly during labour. This study aims to assess the effectiveness of different analgesic drugs used for labour analgesia in a tertiary care hospital. The main objectives of this study were to evaluate the demographic profile of the study subjects, compare the effectiveness of different analgesic drugs for labour analgesia.
Materials & Methods: A prospective observational study was conducted involving 148 pregnant women admitted with labour pain in the obstetrics and gynaecology department at GSVM medical college, Kanpur. The study participants received analgesic drugs, diclofenac with epidosin, tramadol with epidosin, and anafortan. pain relief was measured using the visual analogue scale (vas). Results: All drugs significantly reduced pain, with VAS scores dropping from 10 to 6 after administration. The duration of the first stage of labour was decreased. Pregnant women receiving tramadol along with epidosin, in primigravida,72.22% of were in age 19-24 years and 27.7% in 25-29 years. In multigravida, 33.3 % in age 19-24 years and 66.6% in 25-29 years. Pregnant women receiving, anafortan, in primigravida, 67.44% were in age 19-24 years and 32.55% in 25-29 years. In multigravida, 20% were in age 19-24 years, 65.71% in 25-29 years and 14.28% in 30-34 years. Conclusion: These analgesics were effective in labour pain management, showing equal effectiveness.
References
2. 2.Madden KL, Turnbull D, Cyna AM, et al. Pain relief for childbirth: The preferences of pregnant women, midwives and obstetricians. Women Birth 2013;26(1):33-40.
3. 3.Liao JB, Buhimschi CS, Norwitz ER. Normal labour: mechanism and duration. Obstet Gynecol Clin North Am 2005 Jun;32(2):145-64,
4. 4.Brennan F, Lohman D and Gwyther L. Access to pain management as a human right. Am J Pub Health 2019; 109(1): 61–65
5. 5.Stables D, Rankin J. Physiology in childbearing: With anatomy and related biosciences. Elsevier Health Sciences 2010 Apr 19.
6. 6.ACOG Practice Bulletin No. 107: Induction of labor. Obstet Gynecol. 2009 Aug;114(2 Pt 1):386-397
7. 7.American College of Obstetricians and Gynaecologists. ACOG practice bulletin no. 209 summary: obstetric analgesia and anaesthesia. Obstet Gynecol 2019; 133(3): 595–97.
8. 8.Niven C, Gijsbers K. A study of labour pain using the McGill Pain Questionnaire. Soc Sci Med 1984; 19(12): 1347–51.
9. Littleford J. Effects on the fetus and newborn of maternal analgesia and anaesthesia: a review. Can J Anesth. 2004;51(6):586–609.
10. Arlier L, Devroe S, Budts W, et al. Cardiac interventions in pregnancy and peripartum–a narrative review of the literature. J Cardiothoracic Vasc Anesth. 2020;34(12):3409-3419.
11. Ethiopia Federal Ministry of Health. Standard of midwifery care practice in Ethiopia. Addis Ababa, Ethiopia: Ethiopia Federal Ministry of Health, 2013.
12. Thomson G, Feeley C, Moran VH, et al. Women’s experiences of pharmacological and non-pharmacological pain relief methods for labour and childbirth: a qualitative systematic review. Reprod Health 2019; 16(1): 71.
13. Arendt KW, Lindley KJ. Obstetric anesthesia management of the patient with cardiac disease. Int J Obstet Anesth 2019; 37:73-85.
14. Benjamin EJ, Virani SS, Callaway CW, et al. Heart disease and stroke statistics—2018 update: a report from the American Heart Association. Circulation 2018;137(12):467-492.
15. Knight M, Bunch K, Tuffnell D, et al. Saving Lives, Improving Mothers’ Care-Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2014-16. National Perinatal Epidemiology Unit: University of Oxford 2018.
16. 16.World Health Organization. World health statistics 2016: Monitoring health for the SDGs sustainable development goals. Geneva: World Health Organization, 2016.
17. Sallmann AR: The history of diclofenac. Am. J. Med. 1986 Apr 28;80(4):29-33.
18. Lee, C.R., McTavish, D. and Sorkin, E.M. (1993) Tramadol. A Preliminary Review of Its Pharmacodynamic and Pharmacokinetic Properties, and Therapeutic Potential in Acute and Chronic Pain States. Drugs, 46, 313-340.
19. Bosenberg AT, Ratcliffe S. The respiratory effects of tramadol in children under halothane anaesthesia. Anaesthesia 1998; 53:960-64.
20. Tarkilla P, Tuominen M, Lindgren L. Comparison of the respiratory effect of tramadol and pethidine. Eur J Anaesthesiology 1998;15;64-7.
21. Trivedi HP. Shah SK. Role of valethemate bromide in cervi cal dilatation. J Obstet Gynaecol Ind 1987;37:764-66.
22. Warke HS, Chauhan AR, Raut VS, Ingle KM. The efficacy of Camylofin Dihydrochloride in acceleration of labor: a randomized double blind trial.
23. Mehra D et al. Int J Reprod Contracept Obstet Gynecol. 2021 Dec;10(12):4488-44
24. 24.Al-Assadi AF. The use of diclofenac for pain relief in the first stage of labour. FS J Pharm Res 2015; 4 : 1-4
25. Sudha P, Somashekara SC, Veerabhadra Goud GK. Tramadol in Labour. Int. J Pharm Biomed Res. 2012; 3(1):49-51.
26. Thakur R, Patidar R. Comparative study of transcutaneous electric nerve stimulation and Tramadol Hydrochloride for pain relief in labour. J Obstet Gynecol Ind. 2004; 54(4):346 350.
27. 27.Nagaria T, Acharya J. Pain relief in labour tramadol versus pentazocine. J Obstet Gynecol India. 2006; 56(5):406-409.
28. Meena J, Singhal P, Choudhary D. J Obstet Gynaecol India. 2006; 56:53-55.