title: Arthroscopic medial meniscus trimming or repair under nerve blocks: Which nerves should be blocked?
abstract: BACKGROUND
  This study aimed to determine the role of the sciatic and obturator nerve blocks (in addition to femoral block) in providing painless arthroscopic medial meniscus trimming/repair.
  
  
  METHODS
  One hundred and twenty patients with medial meniscus tear, who had been scheduled to knee arthroscopy, were planned to be included in this controlled prospective double-blind study. The patients were randomly allocated into three equal groups; FSO, FS, and FO. The femoral, sciatic, and obturator nerves were blocked in FSO groups. The femoral and sciatic nerves were blocked in FS group, while the femoral and obturator nerves were blocked in FO group. Intraoperative pain and its causative surgical maneuver were recorded.
  
  
  RESULTS
  All the patients (n = 7, 100%) in FO group had intraoperative pain. The research was terminated in this group but completed in FS and FSO groups (40 patients each). During valgus positioning of the knee for surgical management of the medial meniscus tear, the patients in FS group experienced pain more frequently than those in FSO group (P = 0.005).
  
  
  CONCLUSIONS
  Adding a sciatic nerve block to the femoral nerve block is important for painless knee arthroscopy. Further adding of an obturator nerve block may be needed when a valgus knee position is required to manage the medial meniscus tear.
authors.affiliation: Department of Anesthesia, Abu Dhabi Knee and Sports Center, Madinat Zayed, Abu Dhabi, UAE.
authors.forename: A M
authors.initials: AM
authors.lastname: Taha
authors.affiliation: Department of Anesthesia, Ain Shams University, Cairo, Egypt.
authors.forename: A M
authors.initials: AM
authors.lastname: Abd-Elmaksoud
keywords: Knee scope; obturator nerve block; sciatic nerve block