Oral paracetamol premedication effect on maternal pain in amniocentesis: a randomised double blind placebo-controlled trial

Abstract

The objective of this study was to evaluate the effectiveness of oral paracetamol premedication in decreasing the maternal pain during amniocentesis. A randomised double blind placebo-controlled trial was conducted. Two hundred and forty participants were equally allocated into two groups (one paracetamol and one placebo). Seven patients were excluded due to their incomplete information. The basic characteristics between the two groups were statistically similar. The pain score anticipated by both groups were not significantly different (VAS score = 5.41 ± 1.97 vs. 5.48 ± 1.83; p = .771). The differences were significant for the pain scores during and after the amniocentesis. Concerning the pain scores during the amniocentesis, they were 3.00 ± 1.90 and 3.79 ± 1.78 for the paracetamol group and the placebo group, respectively (p = .001). As for pain scores two hours after the amniocentesis, they were 0.32 ± 0.76 for the paracetamol group and 2.00 ± 1.55 for the placebo group (p < .001). In conclusion, oral paracetamol premedication is effective in decreasing maternal pain both during and two hours after amniocentesis.Impact StatementWhat is already known on this subject? Amniocentesis is reported as a painful prenatal invasive procedure that many women refuse to undertake due to their fear of pain. Since amniocentesis is important for the diagnosis of foetal anomalies, various methods aim to relieve the pain resulting from the procedure. The location of the needle insertion on the upper third of the uterus and cryoanalgesia are effective methods for relieving the pain during amniocentesis but they were difficult to apply. Paracetamol is a common drug for relieving pain and is safe for pregnant women, thus it is interesting to explore whether it is effective in decreasing pain during amniocentesis.What the results of this study add? Paracetamol is effective in decreasing the maternal pain during and after amniocentesis.What the implications are of these findings for clinical practice and/or further research? Pregnant women who need amniocentesis should be counselled that paracetamol could be administered for relieving the pain that may occur from the procedure. However, further study should be conducted to find the optimal dosage of paracetamol for relieving the pain in amniocentesis along with a large RCT with a long-term follow-up to evaluate the side effects of paracetamol.