Intervention group: Psoas sheath Block

Participants in the psoas sheath block arm will receive a psoas sheath block preoperatively under direct ultrasound guidance as follows:

Preparation:

Standard skin sterilisation, prepping, and draping will be applied to the block area.

Ultrasound Guidance:

Anatomical landmarks will be identified using a curvilinear low-frequency (2-5 MHz) ultrasound probe.

Local Anaesthetic Administration:

A 22 G, 100mm needle will be inserted using the in-plane technique and advanced to the target site.

A bolus of 40 ml of 0.375% ropivacaine will be injected into the subpsoas fascial plane.

The procedure will be performed by experienced anaesthesiologists to ensure accuracy and safety.

Control group: Fascia Iliaca Compartment Block

Participants in the fascia iliaca compartment block arm will receive a fascia iliaca block preoperatively under direct ultrasound guidance as follows:

Preparation:

Standard skin sterilisation, prepping, and draping will be applied to the block area.

Ultrasound Guidance:

Anatomical landmarks will be identified using a linear high-frequency (6-13 MHz) ultrasound probe.

Local Anaesthetic Administration:

A 22 G, 50 mm needle will be inserted using the in-plane technique and advanced beneath the fascia iliaca.

A bolus of 40 ml of 0.375% ropivacaine will be injected into the fascia iliaca compartment.

The procedure will be performed by experienced anaesthesiologists to ensure accuracy and safety.

Dose adjustments will be made if the patient weighs <50kg to reduce the risk of local anaesthetic systemic toxicity.

Intervention group: Subpsoas Fascial Plane Block

Participants in the subpsoas fascial plane block arm will receive a psoas sheath block preoperatively under direct ultrasound guidance as follows:

Preparation:

Standard skin sterilisation, prepping, and draping will be applied to the block area.

Ultrasound Guidance:

Anatomical landmarks will be identified using a curvilinear low-frequency (2-5 MHz) ultrasound probe.

Local Anaesthetic Administration:

A 22 G, 100mm needle will be inserted using the in-plane technique and advanced to the target site.

A bolus of 40 ml of 0.375% ropivacaine will be injected into the subpsoas fascial plane.

The procedure will be performed by experienced anaesthesiologists to ensure accuracy and safety

Quality of Recovery 15 (QOR 15) score is a patient reported score used to assess quality of recovery after surgery. The lowest value is 0 and the highest is 150. The higher value signifies better recovery. It will be administered to patients pre-operatively to establish a baseline and then repeated at 24 and 48 hours to assess recovery status

The total 24-hour oxycodone (and morphine-equivalent consumption) will be recorded, documenting all administered doses

This is a scale assessing patient reported pain from 0 to 10, with 10 being the most severe pain