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Oral tramadol versus oral celecoxib for analgesia after mediolateral episiotomy repair in obese primigravidae: a randomized controlled trial


Introduction and hypothesis

A variety of pharmacological and non-pharmacological interventions have been investigated, with the goal of relieving pain after post-episiotomy repair. We aimed to compare the efficacy of tramadol versus celecoxib orally in reducing pain after mediolateral episiotomy repair in obese primigravidae undergoing spontaneous vaginal delivery.


We conducted a randomized double-blinded trial in Cairo University hospital, Cairo, Egypt, from October 2018 to December 2019. We randomly assigned 200 women into two groups: group A (n = 100) received one tramadol tablet 100 mg orally whereas group B (n = 100) received one celecoxib tablet 200 mg orally. Our primary outcome was pain score using a 10-cm visual analog scale at different time intervals. Our secondary outcomes were the overall satisfaction score and drug side effects.


After mediolateral episiotomy repair, the pain scores at 1, 2, and 4 h were significantly lower in the tramadol group than in the celecoxib group (p < 0.001). However, there were no significantly differences in pain scores at 8 and 12 h between the two groups (p = 0.50 and 0.48 respectively). Women’s satisfaction score was significantly higher in the tramadol group than in the celecoxib group (p < 0.001). Fewer participants in the tramadol group needed additional analgesics than in the celecoxib group; however, the difference was not significant (p = 0.17). Drug adverse effects were comparable in the two groups.


Primigravid women who received tramadol 100 mg orally after mediolateral episiotomy repair had lower pain scores and were more satisfied than women who received celecoxib 200 mg orally. Both drugs were well tolerated, with few side effects.

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We thank Mrs. Yasmin Samir Negm (Teacher at Om El Momineen Primary School, Helwan, Egypt) for her invaluable efforts in recording and organizing study data and computer works. In addition, she checked the manuscript for grammatical and style mistakes.


No funding received for this research.

Author information




Dina Latif: project development, data collection, and manuscript writing; Fatma Faisal Darweesh: manuscript writing; Omneya M. Osman: data analysis; Ahmed Mohamed Abdelhakim: manuscript writing; Hala Nabil: data analysis. Ahmed S.A. Ashour: manuscript writing.

Corresponding author

Correspondence to Ahmed Mohamed Abdelhakim.

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Latif, D., Darweesh, F.F., Osman, O.M. et al. Oral tramadol versus oral celecoxib for analgesia after mediolateral episiotomy repair in obese primigravidae: a randomized controlled trial. Int Urogynecol J 32, 2465–2472 (2021).

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  • Tramadol
  • Celecoxib
  • Episiotomy
  • Obese
  • Primigravidae