Comparison of fascia iliaca compartment block and 3-in-1 block in adults undergoing knee arthroscopy and meniscal repair

Peripheral nerve blocks have become a popular method for treatment of pain after lower-extremity surgical procedures. Two peripheral nerve blocks for knee arthroscopy include the 3-in-1 block and the fascia iliaca compartment block (FICB). There is limited research comparing the efficacy of these blocks in adults undergoing knee arthroscopy and meniscal repair who receive both the peripheral nerve block and general anesthesia. This was a randomized controlled trial of 60 adult patients undergoing knee arthroscopy under general anesthesia and with a 3-in-1 block or FICB using the same local anesthetic admixture. Onset of block, time to postoperative analgesic requirements, pain scores, and overall satisfaction scores were measured. No differences in analgesic requirements or pain scores were noted. A faster onset of anesthesia occurred in the 3-in-1 block group, but there was a longer duration of postoperative analgesia in the FICB group. Patient satisfaction scores were similar between groups. Based on this study we recommend that the choice of block can be determined by the clinical scenario. We recommend a 3-in-1 block if speed of onset is the primary goal of anesthesia before induction, and we recommend the FICB block if prolonged postoperative analgesia is the primary goal.