الفهرس 
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Abstract
Post-caesarean section pain is an important issue in obstetrics. Several studies have shown the importance of adequate postoperative analgesia on mobilization, rehabilitation, and decreasing the length of hospital stay. Large amounts of opioid analgesic drugs are often required in the management of intense post-operative pain. However this option is associated with many side effects.
The aim of the study is to assess the effectiveness of cesarean section wound infiltration with local bupivacaine on post-operative pain relief and its effectiveness on starting early ambulation
Populations of the study were comprised of 200 pregnant full term female, going to have cesarean section.
All patients had cesarean section under general anesthesia and received post-operative analgesia in form of nalbuphine IV when Vas > 4 and before recovery from anaesthesia by 10 minutes. Pain was assessed using a 10 points visual analogue scale (VAS) after 1, 4, 6, and 12 hours post-operatively. The amount of nalbuphine consumed after 1, 4, 6, and 12 hours was calculated.
They have been randomized into 2 groups:
1-The 1st group A (n=100 patients ):
The wound was infiltrated after closure with 20ml of 0.9% saline. Patient received 10 mg nalbuphine IV when Vas >4 during the immediate postoperative period for the first 12 hours.
2-The 2nd group B (n=100 patients ):
The wound was infiltrated after closure, and before recovery from anaesthia with 20 ml of 0.25% bupivacaine.
Patient received 10mg nalbuphine IV (when Vas > 4 ) during the immediate postoperative period for the first 12 hours.
The infiltration of wound of cesarean section with 20ml of 0.25% bupivacaine after performance of caesarian section under general anaethesia provided a significant degree of analgesia as shown by smaller pain scores and reduction in nalbuphine consumption.
The use of bupivacaine in infiltration of wound of caesarean Section provides early ambulation.