PENG Block vs Suprainguinal FICB vs Lumbar ESPB for Analgesia After Hip Surgery

Inclusion Criteria: * Adults aged 65 years or older scheduled to undergo elective hip arthroplasty under spinal anesthesia. * Ability to provide written informed consent. * Ability to understand and reliably use numerical pain assessment tools (NRS 0-10). * ASA physical status II-III. * Expected postoperative hospitalization of at least 48 hours to ensure complete data collection. Exclusion Criteria: * Inability to provide informed consent due to cognitive impairment, language barrier, or severe hearing/speech limitations. * Coagulopathy or therapeutic anticoagulation not meeting safety criteria for regional anesthesia. * Local infection at the planned block site. * Allergy, hypersensitivity, or contraindication to ropivacaine, local anesthetics, or study medications. * Pre-existing lower-limb neurological deficits (motor or sensory) affecting outcome assessments. * Severe spinal deformity or anatomical limitations preventing safe performance of regional blocks. * Chronic opioid use (defined as \>30 mg oral morphine equivalents daily for more than 2 weeks). * Severe renal failure (eGFR \<30 mL/min/1.73m²) or severe hepatic impairment. * Uncontrolled diabetes mellitus (fasting glucose \>300 mg/dL or HbA1c \>10%). * History of local anesthetic systemic toxicity (LAST). * Participation in another interventional clinical trial within the past 30 days. * Any condition deemed by investigators to interfere with protocol adherence, safety monitoring, or outcome reliability.