Back ground and Aim: Pain is a sensational and emotional experience due to tissue injury .The main aim for post–caesarean section analgesia are to provide adequate pain relief, encourage early ambulation, and minimize side–effect in both the mother and the baby.

 This study was aimed to evaluate the clinical efficacy of subcutaneous injection of ketamine or clonidinealong with bupivacaine at the incision site to reduce caesarean section pain.

 Method: Fifty patients, aged between 20 and 35 years old, scheduled for elective caesarean section, under spinal anaesthesia were enrolled to this double–blind, randomized,comparative study. Patients were divided into two groups of 25 patients in each group.Group–K (n=25): received 50 mg of ketamine added to 20ml of 0.25% of bupivacainesubcutaneously in the incision site .Group C (n=25): received 75μg of clonidine added to 20ml of 0.25% of bupivacaine.

The first analgesic request, the pain intensity score, sedation score and adverse effects were evaluated for 24 hours.

Statistical analysis– The quantitative data was analyzed by applying one way –ANOVA and post hoc test –Tuckey for the intergroup comparison. Chi–Square test or Kruskal–Wallis test was used for the analysis of qualitative data.

Results: The first time analgesic requested was longer in clonidine group as compared to ketamine group. (P < 0.05). VAS score was significantly lower in groups Cas compared to group K (P < 0.05).

Conclusions: Patients who receivedclonidine with bupivacaine after caesarean section subcutaneously at incision site had lower pain intensity and longer total duration of analgesia in comparison to ketamine without any significant side effects.