283 patients undergoing knee arthroscopy were randomized to receive either an adductor canal nerve block (ACB; n=142) or an intra-articular injection of local anesthetic (IAB; n=141). Outcomes of interest were postoperative pain control, measured using the visual analog scale (VAS), total narcotic consumption at 12, 24, and 48 hours postoperatively, the incidence of ibuprofen use, and the incidence of adverse events. Overall, the results of the study revealed that IAB patients had significantly lower pain scores at 1 and 2 hours postoperatively compared to ACB patients, with a trend towards lower scores up to 16 hours, though not statistically significant. There were no significant differences in narcotic consumption between the two groups. These findings suggest that intra-articular anesthetic may provide better early postoperative pain control following knee arthroscopy.