An anti-extravasation sheath includes a tube sized and dimensioned to permit fluid flow between the inner surface of the tube and an outer surface of an arthroscopic instrument when the arthroscopic instrument is disposed within the tube. A plurality of ribs extending inwardly from the inner surface of the tube and running longitudinally along the tube form a seal between the outer surface of the arthroscopic instrument, thus defining outer lumens between the outer surface of the arthroscopic instrument and the inner surface of the tube. At least one drainage lumen extending longitudinally along the tube and disposed within the ribs is in fluid communication with at least one drainage aperture disposed on the central portion of the tube. The sheath further includes at least one inflow/outflow hole disposed on the distal portion of the tube in fluid communication with at least one outer lumen defined between the outer surface of the arthroscopic instrument and the inner surface of the tube when the arthroscopic instrument is disposed within the tube.