the central sensitization is to completely block

the assumption that the only
way to prevent central sensitization is to completely
block any pain and afferent signals from the surgical wound from the time of incision until final wound healing. This
concept focuses on the intensity and duration of the analgesic intervention
rather than on timing (8) It is believed
that by applying an analgesic medicine or technique, pain will either subside
or be prevented prior to the painful
stimulus, thus preventing central sensitization and consequentlydecreasing the
need for postoperative analgesia(10). Owing to this ‘protective’ effect on the nociceptive system,
pre-emptive analgesia has the potential to be more effective than  a similar analgesic treatment initiated after
surgery. Theoretically, immediate postoperative pain may be reduced and the development of chronic
pain may be prevented. Although some
clinical studies have demonstrated significant effects on acute postoperative
pain, no major clinical benefits of
pre-emptive analgesia have been documented. Other pharmacological
interventions, including anti hyperalgesic drugs such as NMDA-receptor
antagonists and gabapentin, may interfere with the induction and maintenance of
sensitization. Future studies will investigate 
the analgesic effect of prolonged multimodal combinations of different classes of ‘traditional’          analgesics        and
‘antihyperalgesics’ on postoperative pain.

(11,12)

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Although several trials
showed that various antinociceptive techniques applied preoperatively were more
effective in reducing postoperative central sensitization phenomena  than     postoperative
administration, reviews of clinical
findings have been mostly negative .However,
there is still a widespread
belief  among clinicians in the efficacy of preemptive analgesia (10)
The aim of this study, therefore,
was. To compare the efficacy of

local tissue infiltration
with lidocaine 1% before CS. At the surgical site, for pain relief after
surgery with other forms of preemptive analgesia : including central nerve
block(spinal anesthesia) and multi modal parentral analgesia. And to confirm
the relationship between the level of pain and serum cortizol level of the
patient (as an index of level of stress)