drotaverin and Labor-Pain

Drotaverine, a spasmolytic, has been found to have potential to achieve a reduction in the duration of labour and prevent prolonged labour.. To compare the effects of intravenous drotaverine hydrochloride with placebo for shortening the duration of active phase of labour in primigravidas.. A double-blind, placebo-controlled randomized trial of 246 primigravidas in active phase of labour at term was conducted. They were randomly (1:1 ratio) administered intravenous 2 ml (40mg) of drotaverine hydrochloride or 2 ml of Vitamin B complex as placebo. The primary outcome measure was the duration of active phase of labour. The secondary outcome measures were cervical dilatation rate, oxytocin augmentation rate, incidence of prolonged labour, labour pain scores, mode of delivery, maternal and neonatal outcomes.. The mean duration of active phase of labour (hour) was significantly lower in the drotaverine group compared to the control (drotaverine; 6.22 ± 2.41 vs placebo; 8.33 ± 3.56; p <0.001). Also, the cervical dilatation rate (cm/hr) was significantly faster in the drotaverine arm (drotaverine; 1.68 ± 1.02 versus placebo; 1.06 ± 0.53, p <0.001). There was a significantly higher probability of faster delivery among women who were given drotaverine (log-rank test, p < 0.001). The oxytocin augmentation rate, incidence of prolonged labour, labour pain scores, mode of delivery, maternal and neonatal outcomes were not significantly different among the groups.. Drotaverine hydrochloride is effective in shortening the duration of active phase of labour without adverse maternal and neonatal outcomes. However, more evidence is needed to explore its role in active phase of labour among primigravid women. Trial registration number: PACTR201810902005232.

Topics: Double-Blind Method; Female; Humans; Infant, Newborn; Labor Pain; Labor, Obstetric; Oxytocin; Papaverine; Pregnancy

To reevaluate the role of the antispasmodic drug drotaverine in shortening the length of the active first stage of labor among nulliparous women.. In a randomized, double-blind, placebo-controlled trial, 422 young nulliparous women admitted to Ain-shams University Maternity Hospital, Cairo, Egypt, in spontaneous labor were initially enrolled between May and December 2012. Drotaverine hydrochloride (40mg) or placebo was given at the start of the active phase of labor and then repeated every 2hours (maximum 3 doses). All participants were consistently managed in accordance with the local institutional intrapartum protocol. The primary outcome was the rate of cervical dilation.. After excluding women who delivered by cesarean, data were analyzed from 320 women. There was a significant difference in post-treatment labor pain scores, duration of the active phase of labor, and rate of cervical dilatation between the 2 groups (P<0.001 for all). There was no difference in maternal adverse effects. Kaplan-Meier survival analysis showed a greater probability of faster delivery among patients treated by drotaverine hydrochloride (log rank test; P<0.001).. Drotaverine hydrochloride was used effectively and safely to shorten the duration of the first stage of labor among nulliparous women with active spontaneous labor. ClinicalTrials.gov: NCT01639027.

Topics: Adult; Double-Blind Method; Female; Humans; Kaplan-Meier Estimate; Labor Pain; Labor Stage, First; Papaverine; Parasympatholytics; Parity; Pregnancy; Time Factors; Young Adult