الفهرس 
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Abstract
This study was conducted at Minia University Hospital during the period from July 2014 and November 2014, the study involved 50patients of either sex, aged 18-60 years old, ASA I & II and undergoing knee arthroscopy under either spinal anesthesia or combined sciatic-three in one femoral nerve block guided by nerve stimulator.
Patients were randomly divided into two equal groups; Group I (PNB group, n=25) received a mixture of 20 ml lidocaine1% and 10 ml bupivacaine 0.5% for each nerve. Group II (Spinal group, n=25) received 3ml of hyperbaric bupivacaine (15mg).
The variables included: heart rate, mean arterial blood pressure, oxygen saturation, sensory and motor blocks, postoperative pain, patient satisfaction score, and complications were recorded.
Heart rate and oxygen saturation were stable with minimal changes while the MAP was significantly decreased in spinal group than PNB group.
The mean onset time of sensory and motor blocks was significantly lower in spinal group (2.04 ± 1.01 min. for sensory) and (4.46 ± 2.11 min for motor) than in PNB group (6.5 ± 3.75 min for sensory) and (16.72 ±9.10 min for motor).
Combined sciatic- 3 in 1 femoral nerve block lead to more effective analgesia with significantly lower VAS values than spinal anesthesia. The duration of analgesia and resolution of sensory and motor block were also significantly prolonged in PNB compared to spinal group. Total postoperative analgesic requirement and number of patientsreceived analgesia were reduced significantly in PNB group in comparison with spinal group.
Percentage of patients who were satisfied by the anesthetic technique was significantly higher in PNB group (100%) than spinal group (88%).
TRD was prolonged significantly in the spinal group compared to PNB group.
We concluded that combined sciatic-three in one femoral nerve block results in prolonged postoperative analgesia, with lower analgesic consumption, higher degree of patient satisfaction, earlier discharge from hospital and lower incidence of complications as compared to spinal anesthesia in patients undergoing knee arthroscopy.