Introduction
acute postoperative pain, postoperative pain, painless, pain
Cesarean section (CS) is one of the most common gynecological surgery, which due to various reasons such as increasing the age of marriage and socioeconomic status of society, its prevalence is increasing.It has been shown that the rates of CS have been increasing globally, as the sustained, unprecedented rise in CS rates is a major public health concern (After all surgeries, including CS, patients inevitably experience pain to varying degrees (The search for the ideal method to manage postoperative pain is ongoing. So far, many studies has been performed for appropriate management of postoperative pain after CS. The multiplicity of studies and modalities indicates the lack of a clear and reliable method in reducing postoperative pain and shows that acute postoperative pain management after CS still remains a problem (Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has been widely studied as an analgesic adjuvant for management of postoperative pain. Previous studies evaluate the efficacy of ketamine for managing postoperative pain and analgesic consumption after CS, with conflicting results (Intranasal route of administration offers a variety of attractive options for local and systemic delivery of different medications. Intranasal administration is noninvasive, painless, easily administered, and relatively safe and is associated with a rapid onset of therapeutic effects and higher bioavailability due to avoid the first- pass effect (