Efficacy of Paracetamol in the Relief of Pain in Advanced Labour: A Randomized Double Blinded Placebo Controlled Study

Introduction: The labour process is associated with pain and may be the most painful experience many women will encounter in their lifetime. Out of all the methods available for pain relief in labour, parenteral opioids are the most popular in developing countries. However, its use is associated with some maternal and neonatal side effects. Paracetamol is a non-opioid analgesic with a lesser incidence of side effects that has been tried in labour pain management. Objective: The aim of this study was to determine the efficacy of paracetamol in the relief of pain in advanced labour. Methodology: A total of 140 pregnant women admitted in advanced labour (6-7cm cervical dilation) were randomised into two equal groups. The control group had a single intravenous dose of 6 ml of water for injections administered slowly, while the experimental group had a single intravenous dose of 6 ml (900 mg) of paracetamol given slowly. Pain was assessed with the Visual Analogue Scale (VAS) just before receiving the study drug and at 30 min, 1 and 2 hours after administration of the drug. Data were coded and entered into the Statistical Package for the Social Sciences (SPSS) for analysis. Results: The pain relief experienced in the paracetamol group was significantly higher than the Placebo group (Mean Difference [mm]: 32.41±2.33, 35.84±2.33, 18.15±2.08 at 30 minutes, 1 hour, 2 hours after administration of paracetamol and placebo, respectively). Conclusions: Intravenous paracetamol is an effective analgesia in the advanced first stage of labour when compared with placebo. Paracetamol could be an alternative analgesia in the advanced stage of labour in low-resourced settings with limited options.