Shaista Rashid, Ayesha Khatoon, Shabnam Hasan, Zaira Batool, Tazeen Fatima Munim, Aftab Imtiaz.
Tramadol infusion as obstetric analgesia.
Pak J Surg Jan ;37(2):131-4.

Objective: To assess the efficacy and safety of tramadol hydrochloride infusion as an analgesic during labor. Study design: Prospective open, interventional study. Place and duration: Gynae and Obstetric Unit II in Abbasi Shaheed Hospital from 1st June 2018 to 30th November 2018. Material and Methods: This is interventional, non randomized, single arm study which was carried out at Abbasi Shaheed Hospital. The study included 100- primi-gravida with singleton term pregnancy. Dose of 100mg of tramadol hydrochloride intravenous infusion in 1000c.c. normal saline was given during active phase of labor. Degree of pain was assessed by using Wong-Baker FACES pain rating scale. We observed maternal and fetal side effects, duration of labor and mode of delivery. Data analyzed by SPSS version 20 for descriptive statistic and student t-test applied for pain scoring before and after analgesia with level of significance >0.01. Result: Obstetric analgesia by giving tramadol infusion were significantly reduced pain score from mean score of 4.1+-0.59 to 1.96+-.618 (p<0.001). There was no significant differences in maternal vitals and fetal heart rate after using analgesia. The duration of 1st stage of labor were 6.8+-1.14 hours and 2nd stage of labor was 41.05+-10.75 minutes. Total 92% women delivered vaginally, 5 by outlet forceps and only 3 had cesarean section. Of these 100 deliveries; 96% babies born with apgar score >= 7 at 1 min, and 99% had apgar score <=7at 5 min, only 2 babies developed respiratory depression. Most of women did not suffer from adverse effects except 2 women experienced nausea. Conclusion: Tramadol infusion is a cost-effective and safe alternative analgesia during labor in low socio-economic setting.

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