(880) Paracetamol versus Ibuprofen for Postpartum Pain control: A Randomized Controlled Trial

The use of opioids for postpartum pain control raises concerns regarding their transfer through breastfeeding and potential side effects. We aimed to compare the pain control efficacy between paracetamol and ibuprofen during the immediate postpartum period.

Study Design:

A randomized controlled interventional study was conducted, including women who underwent vaginal delivery and provided informed consent for participation. When participants requested pain relief at any time during their hospitalization, they were randomly assigned treatment in a double-blind manner using pre-prepared envelopes containing either 400 mg of Ibuprofen or 1000 mg of paracetamol. Women who had undergone a cesarean section had a known sensitivity to any of the study drugs, had preeclampsia, pre or gestational diabetes, a history of depression, or chronic pain or fibromyalgia, were excluded from participation in the study.

Pain level was reported using the Numeric Rating Scale (NRS) at various time points immediately after treatment (T0), one, four, and six hours after treatment (T1, T4, and T6, respectively). The indicated site of the most intense pain and the need for additional analgesia were recorded. The study also evaluated the impact of pain control on breastfeeding initiation, mobilization, and urination.

Results:

1. 
   

   There were no differences in demographic characteristics and perinatal outcomes between the two study groups.
   



2. 
   

   No significant differences were found in the interval from delivery to demand for pain control between the groups (8±6-10.5 hours and 11±6-16 hours for the paracetamol and ibuprofen groups respectively, p-value = 0.13).
   



3. 
   

   Pain scores by NRS were similar between the groups for the paracetamol and ibuprofen groups (table)
   



4. 
   

   No significant differences were noted in breastfeeding initiation, mobilization, urination, or the need for additional analgesia between the groups.
   

This study suggests comparable effectiveness of paracetamol and Ibuprofen for immediate postpartum analgesia and both medications can be considered as a non-opioid alternative for postpartum pain control.