الفهرس 
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Abstract
Delivering infants through Cesarean section is growing to be one of the most frequent operative procedure performed world wide.
Breastfeeding is natural and economical act, that build up special emotional bond between mother and her newly born baby.
Large amounts of opioid analgesic drugs are often required in the management of intense post operative pain, as this option is associated with many side effects, including evident disruption of mother/newborn bonding. Local anesthetics either on their own or in combination with opioids or nonsteroidal anti-inflammatory drugs have been employed as an adjunct to other postoperative pain relief strategies.
The aim of study is to assess the effectiveness of local anesthetic agent wound infiltration on post cesarean section pain relief and its effectiveness on starting lactation.
100 pregnant full term females had elective cesarean section after explanation of aim and details of our study and after obtaining a written consent.
All patients had cesarean section under spinal anesthesia and received post-operative analgesia [pethidine] according to visual analogue scale value, pain was assessed 15 minutes after skin closure using a 100 point visual analogue scale (VAS) which was continued at 1,2,4,8,16 and 24 hours postoperatively, the amount of pethidine consumed after 1,2,4,8,16 and 24 hours was calculated, onset of lactation was recorded.
They have been randomized into 3 group:
1-The 1st group C (n=50 women)
Patients only received pehidine post-operative according to visual analogue scale.
2-The 2nd group B (n=25 women):
The wound was infiltrated during closure, with 30 ml of 0.5 % bupivacaine.
3-The 3rd group B+M (n=25 women)
The wound was infiltrated during closure with 30 ml of 0.5 % bupivacaine plus 750 mg MgSO4.
Blood sample collected before surgery and after surgery by 2hours and level of magnesium in blood was calculated.
The present study reveald that:
• The infiltration of the surgical wound of a cesarean section with 0.5 % bupivacaine, with or without the addition of magnesium after spinal anaethesia provided a significant degree of analgesia as shown by the smaller pain score and pethidine consumption.
• The use of local anesthetics in wound infiltration in cesarean section help mother to lactate earlier.