We report successful management of anesthesia in two cases of knee arthroscopic surgery of meniscal lesions using ultrasound-guided combined femoral-obturator nerve block with inhalation anesthesia. The blocks were performed with 30 ml of 0.5% ropivacaine under ultrasonographic visualization. The perioperative courses were uneventful and there was no complaint about postoperative pain. Unlike spinal or epidural anesthesia, combined femoral-obturator nerve block has advantages of no muscle weakness in healthy lower limbs, no urinary retention, and no post dural puncture headache. Our technique relieved postoperative pain effectively because knee joint is innervated by the femoral and obturator nerves in great measure. Ultrasound-guided femoral and obturator nerve block is easier and more successful than sciatic nerve block. General anesthesia with combined femoral-obturator nerve block could be a useful technique with less complication for knee arthroscopic surgery.
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