69 patients undergoing arthroscopy of the wrist under general anesthesia were included in this trial to evaluate the use of two different forms of postoperative analgesia. Patients were randomized to receive intra-articular and portal infiltration or a wrist block; both procedures were performed using levo-bupivacaine. Median pain scores did not differ at 30 and 60 minutes postoperatively. Median pain scores were significantly lower in the wrist block group on the night of surgery and 24 hours postoperatively. The results from this study indicate that a wrist block may provide better postoperative analgesia following wrist arthroscopy procedures and avoid the potential risk of chondrotoxicity. Additional, large scale randomized controlled trials are needed to further evaluate these procedures before definitive conclusions can be made.