The investigators are evaluating postoperative outcomes in patients undergoing hip replacement surgery performed with either spinal or general anesthesia, who also receive a suprainguinal fascia iliaca block using either perineural ropivacaine alone or ropivacaine combined with dexmedetomidine.

Patients undergoing hip replacement surgery often receive a single-shot suprainguinal fascia iliaca block as a part of the primary anesthetic and multimodal postoperative analgesic strategy. However, the analgesic effect of a single-shot block typically diminishes after several hours and may be inconsistent beyond 24 hours. Adding dexmedetomidine, an alpha-2 agonist, to the local anesthetic has been shown to prolong block duration and reduce postoperative opioid requirements. Investigating its use in suprainguinal fascia iliaca blocks for total hip arthroplasty may clarify its clinical effectiveness. The investigators hypothesize that patients receiving ropivacaine with dexmedetomidine will have a significantly longer time to first analgesic request compared to those receiving ropivacaine alone.

Inclusion Criteria:

• Patients undergoing elective total hip arthroplasty
• 18-80 years old
• ASA 1-3 classifications

Exclusion Criteria:

• ASA classification of 4 or greater
• Infection at the site of nerve blockade
• Coagulopathy
• Known allergy to study medications
• Chronic opioid consumption (>3 months)
• Currently using lidocaine patches
• Pre-existing neuropathy
• A history of CVA
• High grade atrioventricular block (cardiac conduction system impairment)
• Organ dysfunction (cardiac failure, respiratory failure, end stage renal disease, hepatic dysfunction, hypoalbuminemia)
• Morbid obesity (≥40 kg/m2)
• Prior surgery in supra and/or infrainguinal region
• Non-English-speaking participants