the aim of this study is to determine the analgesic effect of iPACK in combination to ACB after the excision of tumors around the Knee regarding the following:
* Time to the 1st rescue analgesia. * Postoperative morphine consumption. * Postoperative visual analogue scale (VAS). This study will include patients, aged 18 to 65 years, belonging to the American Society of Anesthesiologists (ASA) physical status II to IV , undergoing excision of tumors around the knee under spinal anesthesia.
Patients will be randomly allocated Group iPACK plus Adductor canal block (ACB) : patients will receive ACB plus iPACK block.
• Control group : patients will not receive any block but will take morphine 3mg bolus at VAS more than 4 and regular NSAIDS and paracetamol iv.
Stated willingness to comply with all study procedures and availability for the duration of the study
American Society of Anesthesiologists (ASA) physical status II-IV.
Patients undergoing excision of tumors around the knee under spinal anesthesia
Patient refusal.
Neuromuscular disorders
Allergy to local anesthetics
Previous history of knee surgery