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IV paracetamol vs other opiates and analgesics
  1. NF Fletcher
  1. James Cook University Hospital, Middlesbrough, UK


Introduction A trial of the use of intravenous Paracetamol in high dependency labouring women at JCUH was undertaken to assess the need for additional pain relief and delivery and neonatal outcome.

Methods Women were offered intravenous Paracetamol as a method of pain relief in labour over a 4 month period. A total of 17 women undertook the trial, a further 34 women were randomly selected as a control group. The two group's outcomes were then compared.

Results A higher number of the Paracetamol group were induced/augmented (65% vs 59%).

The use of syntocinon was higher in the Paracetamol group (82% vs 53%).

Epidural rates were lower in the Paracetamol group (35% vs 50%).

The second stage of labour was less than 60 min in 59% of the Paracetamol group vs 38% in the control group.

59% of the Paracetamol group had a normal vaginal delivery vs 50% in the control group.

The operative vaginal delivery rates were less in the Paracetamol group (24% vs 30%).

There was no difference in apgar scores (7–10) at 5 min (94% vs 91%).

There were no neonatal admissions in the Paracetamol group. Numbers are too small to comment.

Summary/Conclusion Although a small pilot study, the reduction in epidural rate and shortened second stage, without detrimental effects, supports extending this trial and the use of intravenous Paracetamol for pain relief in labour. Our plan is to introduce, monitor and re-evaluate it within our practice.

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