Introduction: The aim of this study was to compare the effect of intravenous acetaminophen with combination of suppository diclofenac and incisional bupivacaine on post cesarean section pain.
 
Materials & methods: This was a double blinded randomized clinical trial study. Patients were randomly allocated to the intravenous acetaminophen group (A) and combination of incisional bupivacaine and diclofenac (B) group. Secondary outcomes included: assessment of the time of first request for analgesic, 24 hr morphine consumption, patient's sleep, sedation score (by Wilson criteria), drug side effects (nausea and vomiting and pruritus) and pain intensity during ambulation and global satisfaction of the patients. Data analysis was done by SPSS software.
 
Findings: There were no significant difference between the mean age and mean weight of groups (p value was 0.15 and 0.41 respectively). During this study, pain score (p<0.001) and morphine sparing effect (p<0.001) in group B was significantly less than group A and in group A patient's  pain started earlier than group B (p<0.001).
 
Discussion & conclusions: We noted that combination of suppository diclofenac and intraincisional bupivacaine could relieve pain better than intravenous acetaminophen and can be used for post cesarean delivery analgesia with more efficacy than intravenous acetaminophen for an opioid-sparing effect.