Tramadol versus hyoscine-N-butylbromide as intrapartum analgesics during the first stage of labor

Abstract

Objective The aim was to evaluate and compare the analgesic efficacy of tramadol versus hyoscine-N-butylbromide intramuscularly given during the active phase of the first stage of labor. Materials and methods This prospective study included 140, American Society of Anesthesiologists I, laboring primigravidae, who were divided into two equal groups: group I (group B) received hyoscine-N-butylbromide (Buscopan) 40 mg intramuscular and group II (group T) received tramadol 100 mg intramuscular. Labor pain was assessed by visual analog scale before and at 30 min, 1 h, 2 h, and 3 h after drug administration. Maternal and neonatal adverse effects, drug-delivery interval, mode of delivery, need for additional analgesia, and postpartum maternal satisfaction were assessed too. Results Baseline visual analog scale scores were comparable between the groups (P>0.05). Pain scores at 30 min, 1 h, 2 h, and 3 h were significantly higher (P<0.001) in group B. Overall, 30 (42.8%) women in group B required additional analgesia versus only seven (10%) women in group T (P<0.001). Drug-delivery interval was significantly (P<0.05) shorter in group B at 175 versus 220 min in group T. Apgar score at 1 min was significantly higher (P<0.05) in group B, whereas the scores at 5 min were comparable (P>0.05). A total of 56 (80%) women in group B had adverse effects versus 54 (77.1%) women in group T (P>0.05). Adverse effects were generally mild (well tolerated). Cesarean delivery percentages were comparable between the groups (P>0.05). Postpartum maternal satisfaction was significantly higher (P<0.001) in group T. Conclusion Although Buscopan is cheap and safe, it is a less effective intrapartum analgesic than tramadol. It offers shorter duration of labor, so it is better recommended for primiparous women.