Paracetamol / Ibuprofen for Postpartum Pain in the Early Postpartum Period

NCT ID: NCT04653506

Last Updated: 2024-02-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

107 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-11-28

Study Completion Date

2023-07-06

Brief Summary

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The investigators will examine the effectiveness of non-opioid analgesia (Paracetamol versus Ibuprofen) in the early postpartum period

Detailed Description

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Postpartum pain is a common problem that leads to difficulties in basic daily activities, overuse of opioid medications, and even impaired breastfeeding ability. Non-opioid analgesia may play an essential role in reducing pain and improving the postpartum period including the ability to breastfeed and caring for the newborn.

This study will compare non-opioid treatment - 1000 mg Paracetamol versus 400 mg Ibuprofen in order to determine the optimal pain relief treatment in the early postpartum period that may decrease the use of opioid analgesia.

The investigators will evaluate the pain by the Numerical Rating Scale (NRS) index in the early postpartum period. The evaluation will conduct at 4-time points - while the women taking the pain relief (time 0), an hour later (time 1), 4, and 6 hours later (time 4 and time 6).

The investigators will compare the analgetic effect of each drug and evaluate the need for additional analgesia whether opioid or not.

Furthermore, the investigators will examine when women sought pain relief and whether pain relief contributes to the ability of Breastfeeding.

Conditions

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Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

* Women participating in the study will receive postpartum analgesia immediately while reporting pain requiring analgesia (NRS \<3)
* Pain Reliefs will be given in a double-blind mechanism, in closed envelopes
* The envelopes will contain Paracetamol 1000 mg or Ibuprofen 400 mg
* Women participating in the study will answer a questionnaire to characterize the pain while taking the pain relief (time 0), an hour later (time 1), 4 and 6 hours later (time 4 and time 6)
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Caregivers
The primary investigator will be the only one to have the information about envelopes contain

Study Groups

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Paracetamol group

Women who were treated with a double-blind mechanism in an envelope containing paracetamol pills (1000 mg)

Group Type EXPERIMENTAL

Paracetamol 1000 mg

Intervention Type DRUG

Women participating in the study will receive postpartum analgesia immediately while reporting pain requiring analgesia, by envelope contains paracetamol 1000 mg or ibuprofen 400 mg

Ibuprofen group

Women who were treated with a double-blind mechanism in an envelope containing Ibuprofen pills (400 mg)

Group Type EXPERIMENTAL

Ibuprofen 400 mg

Intervention Type DRUG

Women participating in the study will receive postpartum analgesia immediately while reporting pain requiring analgesia, by envelope contains paracetamol 1000 mg or ibuprofen 400 mg

Interventions

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Paracetamol 1000 mg

Women participating in the study will receive postpartum analgesia immediately while reporting pain requiring analgesia, by envelope contains paracetamol 1000 mg or ibuprofen 400 mg

Intervention Type DRUG

Ibuprofen 400 mg

Women participating in the study will receive postpartum analgesia immediately while reporting pain requiring analgesia, by envelope contains paracetamol 1000 mg or ibuprofen 400 mg

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Women between the ages of 18-50, who gave birth in a vaginal birth

Exclusion Criteria

* Sensitivity to Paracetamol or Ibuprofen
* After cesarean section
* Received analgesia prior to study recruitment
* Perineal tears grade 3 \\ 4
* Women with chronic pain, rheumatic disease, fibromyalgia, or trauma
* Women with a diagnosis or medication for anxiety or depression
* Dropout for women whose newborns needed respiratory support with intubation, cooling, prolonged hospitalization in NICU exceeding one week
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Tel-Aviv Sourasky Medical Center

OTHER_GOV

Sponsor Role lead

Responsible Party

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Shmuel Kivity, MD

director head of clinical trails department, principal investigator, clinical professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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shai ram, MD

Role: PRINCIPAL_INVESTIGATOR

Tel Aviv Medical Center

Locations

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Tel Aviv Medical Center

Tel Aviv, , Israel

Site Status

Countries

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Israel

References

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Macarthur AJ, Macarthur C. Incidence, severity, and determinants of perineal pain after vaginal delivery: a prospective cohort study. Am J Obstet Gynecol. 2004 Oct;191(4):1199-204. doi: 10.1016/j.ajog.2004.02.064.

Reference Type BACKGROUND
PMID: 15507941 (View on PubMed)

Fahey JO. Best Practices in Management of Postpartum Pain. J Perinat Neonatal Nurs. 2017 Apr/Jun;31(2):126-136. doi: 10.1097/JPN.0000000000000241.

Reference Type BACKGROUND
PMID: 28277399 (View on PubMed)

Eisenach JC, Pan PH, Smiley R, Lavand'homme P, Landau R, Houle TT. Severity of acute pain after childbirth, but not type of delivery, predicts persistent pain and postpartum depression. Pain. 2008 Nov 15;140(1):87-94. doi: 10.1016/j.pain.2008.07.011. Epub 2008 Sep 24.

Reference Type BACKGROUND
PMID: 18818022 (View on PubMed)

Peahl AF, Dalton VK, Montgomery JR, Lai YL, Hu HM, Waljee JF. Rates of New Persistent Opioid Use After Vaginal or Cesarean Birth Among US Women. JAMA Netw Open. 2019 Jul 3;2(7):e197863. doi: 10.1001/jamanetworkopen.2019.7863.

Reference Type BACKGROUND
PMID: 31348508 (View on PubMed)

Deussen AR, Ashwood P, Martis R. Analgesia for relief of pain due to uterine cramping/involution after birth. Cochrane Database Syst Rev. 2011 May 11;(5):CD004908. doi: 10.1002/14651858.CD004908.pub2.

Reference Type BACKGROUND
PMID: 21563142 (View on PubMed)

Wuytack F, Smith V, Cleary BJ. Oral non-steroidal anti-inflammatory drugs (single dose) for perineal pain in the early postpartum period. Cochrane Database Syst Rev. 2016 Jul 14;7(7):CD011352. doi: 10.1002/14651858.CD011352.pub2.

Reference Type BACKGROUND
PMID: 27412362 (View on PubMed)

Davies NM. Clinical pharmacokinetics of ibuprofen. The first 30 years. Clin Pharmacokinet. 1998 Feb;34(2):101-54. doi: 10.2165/00003088-199834020-00002.

Reference Type BACKGROUND
PMID: 9515184 (View on PubMed)

Chou D, Abalos E, Gyte GM, Gulmezoglu AM. Paracetamol/acetaminophen (single administration) for perineal pain in the early postpartum period. Cochrane Database Syst Rev. 2013 Jan 31;(1):CD008407. doi: 10.1002/14651858.CD008407.pub2.

Reference Type BACKGROUND
PMID: 23440827 (View on PubMed)

Ram S, Madar D, Ram HS, Peleg G, Lior Y, Greenfeld A, Yakov G, Yogev Y, Maslovitz S. Paracetamol versus ibuprofen for early postpartum pain control: a randomized controlled trial. Arch Gynecol Obstet. 2025 Jul;312(1):51-57. doi: 10.1007/s00404-024-07797-4. Epub 2024 Nov 5.

Reference Type DERIVED
PMID: 39499309 (View on PubMed)

Other Identifiers

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0368-20-TLV

Identifier Type: -

Identifier Source: org_study_id

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