Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 7 3 2021 07 31 180 182 EN Sina Hassannasab Department of Anesthesiology and Intensive Care, Golestan University of Medical Sciences, Golestan, Iran. Avasadat Mirkatouli Department of Anesthesiology and Intensive Care, Golestan University of Medical Sciences, Golestan, Iran. Ali Jabbari Department of Anesthesiology and Intensive Care, Golestan University of Medical Sciences, Golestan, Iran. 2021 01 24 2021 02 13 Pethidine was the first synthetic opioid to be used to provide analgesia in humans and was shown also to have local anesthetic activity comparable with that of cocaine. The neonatal Apgar score after birth is an important factors of mortality of the newborn. In this regard, the type of drug used for the cesarean section is very important in the Apgar score of the cesarean section. Pethidine is an intermediate lipid-soluble opioid with both a postoperative analgesic mechanism and a sensory block which is known as the only opioid which can be used alone in the cesarean section under spinal anesthesia. We used pethidine as an alternative to bupivacaine in patients going under cesarean section. https://aacc.tums.ac.ir/index.php/aacc/article/view/332