Ibuprofen Versus Acetaminophen for the Relief of Perineal Pain After Childbirth: A Randomized Controlled Trial
Rungtiwa Kamondetdecha MD*, Yuen Tannirandorn MD*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok
Objectives: To evaluate efficacy of ibuprofen compared with acetaminophen for relief of perineal pain after
childbirth, side effects of ibuprofen compared with acetaminophen and patient satisfaction in treatment
between the 2 groups
Material and Method: A total of 210 women who gave birth by spontaneous vaginal delivery with mediolateral
episiotomy between June 2006 and November 2006 were randomly assigned to receive either ibuprofen (400
mg) (n = 106) or acetaminophen (1000 mg) (n = 104), both given orally when suturing was completed. Pain
ratings were recorded before the treatment and at 1, 2, 3 and 4 hours after the treatment on a 10-cm visual
analogue scale. Side effects and patient satisfaction were assessed at 24 hours.
Results : Pain in the ibuprofen group was considerably more reduced than the acetaminophen group at 1
hour of treatment (mean pain rating 2.18 vs. 2.88, respectively; p < 0.003). Even though, at 2, 3 and 4 hours
of treatment ibuprofen seemed to give more relief of pain than acetaminophen, they did not reach statistically
significant differences (mean pain rating; at 2 hour: 1.59 vs. 1.97, p = 0.093; at 3 hour: 1.08 vs. 1.31, p =
0.183; and at 4 hour: 0.69 vs. 0.85, p = 0.169; respectively). There were no side effects and no significant
differences in overall patient satisfaction between the two groups.
Conclusion : Ibuprofen was consistently better than acetaminophen at 1 hour after treatment for relief of
perineal pain after childbirth without any side effects. After 2 hours, ibuprofen and acetaminiphen had
similar analgesic properties.
Keywords : Episiotomy, Prineal pain, Ibuprofen, Acetaminophen
