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Background: Cesarean section (CS), one of the most common major operative procedures, performed all over the world. Incisional infiltration with local anesthetics is a simple, cheap and effective mean of providing good analgesia for surgical operations without any major side effects & allowing early patients’ mobilization & postoperative recovery, so the purpose of study is to compare between the effect of wound infiltration with bupivacaine versus pethidine for post cesarean section pain relief. Patients and Methods: A randomized controlled trial (RCT) was conducted in Ain Shams University Maternity hospital in the period from August 2016 and January 2017. 100 full term pregnant females randomized into two groups: Group A (50 patients) Bupivacaine group: Subcutaneous and subrectal infiltration with 10 ml 0.25% Bupivacaine (2.5 mg/ml) diluted in 10 ml normal saline before closure of the wound was done; Group B (50 patients) Pethidine group: Subcutaneous and subrectal infiltration with 1 ml pethidine (50 mg/ml) diluted in 19 ml normal saline before closure of the wound was done. All patients had cesarean section under spinal anesthesia. Study outcome measures post-operative pain scores using visual analogue scale, post-operative analgesia requirement time to first rescue analgesia, onset of mobilization, side effect of local anesthetic, wound infection (after one week). It was registered on clinical trials.gov with ID: NCT03652116. Results: Visual analogue scale values differ significantly between pethidine group and that of bupivacaine at rest and on coughing at 4, 8, 12, 24 hours & analgesic consumption (P value < 0.05). There is high statistical significant difference in 1st time request analgesia per minute comparing group A to group B (P value 0.001). There is no significant difference between bupivacaine and pethidine regarding time of ambulation, side effects or complications. Conclusion: Infiltration of the wound of cesarean section with pethidine gives effective analgesia for several hours as compared to Bupivacaine.

Subrectal and Subcutaneous Wound Infiltration with Bupivacaine versus Pethidine for Post Cesarean Section Pain Relief: Randomized Controlled Trial