Does Paracetamol Offer Effective Pain Relief Compared with Meperidine in Primiparous Women in Labor? A Randomized Controlled Trial | ||
| Evidence Based Women's Health Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 01 October 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ebwhj.2025.428717.1518 | ||
| Authors | ||
| Ibrahim Fawzy* 1; Mohamed Ahmed Hussein2; Gamal Gamal Eldeen Yousef3; Kareem Ashraf MohyiEldeen Mohamed Fawzy4 | ||
| 1Lecturer of obstetrics and gynecology, Faculty of medicine, Cairo University | ||
| 2Cairo university, kasralainy | ||
| 3Obstetrics and Gynecology Department, faculty of medicine, Kasr EL-Ainy Hospital, Cairo University, Cairo, Egypt | ||
| 4assistant lecturer of obstetrics and gynecology, faculty of medicine, New Giza University | ||
| Abstract | ||
| Background: Labor pain is intense and often requires pharmacological management. Meperidine, a widely used opioid, is effective but associated with maternal and neonatal side effects. Paracetamol, a non-opioid analgesic, offers a potentially safer alternative. This study aimed to compare the analgesic efficacy, maternal tolerance, and neonatal outcomes of paracetamol versus meperidine for intrapartum pain relief in primiparous women. Patients and Methods This randomized controlled trial included 112 primiparous women at term admitted in spontaneous active labor (3–4 cm cervical dilatation). Participants were randomly assigned to receive either 1000 mg intravenous paracetamol (Group I) or 50 mg intramuscular meperidine (Group II). Pain severity was assessed by Visual Analog Scale (VAS) at baseline, 15, 30, 60, and 120 minutes. Primary outcome was pain relief; secondary outcomes included labor duration, maternal side effects, and neonatal Apgar scores. Results: Baseline characteristics were comparable between groups. Both agents provided similar analgesic efficacy, with no significant differences in mean VAS scores up to 120 minutes (p > 0.05). Duration of the active and second stages of labor did not differ significantly. Maternal adverse effects (dizziness, nausea, vomiting) were significantly higher with meperidine (all p < 0.001). The need for additional analgesia was greater in the paracetamol group (62.5% vs. 35.7%, p = 0.004). Neonatal outcomes were superior with paracetamol, with significantly higher 1- and 5-minute Apgar scores (p < 0.0001). Conclusion: Paracetamol and meperidine provide comparable analgesia during labor, but paracetamol is associated with fewer maternal side effects and improved neonatal outcomes | ||
| Keywords | ||
| Labor analgesia; Paracetamol; Meperidine; Primiparous | ||
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