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Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submissionBackground and Aims Different analgesia pathways exist for total hip replacement surgery (THR). We analyzed a difference in efficacy, safety and satisfaction of analgesia depending on analgesia pathways for THR surgeries.Methods Prospectively 31 ASA II – III, 8 male, age 67.8 ± 6.7 y. THR surgery were analyzed. Approval No. 2-PĒk-4/335/2025. Spinal anesthesia (SA) with isobaric Bupivacaine 0.5% 2.8 ml and either intrathecal morphine 100 mcg (M group, n = 10), fascia iliaca infraingvinal block with Bupivacaine 0.25% 30 ml (FIB group, n = 11), intrathecal morphine 50 mcg and FIB (M +FIB group, n =10) and multimodal analgesia after surgery were used. As a primary outcome pain intensity (NRS scale) 8 and 24 hours (h) after surgery, secondary – satisfaction (QoR 15 scale), safety issues were analyzed. SPSS, p< 0.05.Results Preliminary results - 8 h pain was higher in FIB (5.8 ± 3.0) vs. M (2.2 ± 2.3) and M+FIB (2.3 ± 2.1); P<0.05. After 24 h pain differed between FIB (4.7 ± 2.1) vs. M (2.1 ± 2.1), not anymore vs. M + FIB (3.5 ± 3.0); p = 0.049, p =0.49, respectively. Difference was not found in QoR 15 scores comparing M (122 ± 16.6), FIB (126.5 ± 16.1), M +FIB (113 ± 32.8). A trend to lower satisfaction in PONV in M (8.1 ± 3.5) vs. FIB (9.91 ± 0.3), M +FIB (9.8 ± 0.4). Hypotension postoperatively was detected in M group for 2, M + FIB for 1 cases.Conclusions Morphine 100 mcg to SA more effectively reduce pain comparing to FIB and lower Morphine dose with FIB after THR without significantly affecting satisfaction. However, PONV, hypotension might be more often expected.