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Background and Aims Effective postoperative pain management is essential for promoting early mobilization and functional recovery following total knee arthroplasty (TKA), particularly within Enhanced Recovery After Surgery (ERAS) protocols. Continuous femoral nerve block (CFNB) and local infiltration analgesia (LIA) are two widely used techniques, though their impact on hospital stay may differ. This study compares the analgesic efficacy and length of hospitalization associated with CFNB and LIA in TKA patients.Methods A retrospective descriptive analysis was conducted involving 82 patients who underwent TKA with CFNB and subgluteal sciatic block in 2022, and 61 patients who received LIA between 2023 and 2024. All procedures were performed under spinal anesthesia. CFNB was maintained postoperatively with 0.2% ropivacaine at 4–6 mL/h. LIA was administered intraoperatively using 100–150 mL of 0.2% ropivacaine, dexamethasone, and adrenaline. Pain was assessed at 24 and 48 hours postoperatively, both at rest and during movement, using the Visual Numeric Scale (VNS). Median hospital stay was also recorded.Results In the CFNB group, mean VNS scores at rest were 1.3 (24 h) and 2.1 (48 h), versus 4.86 and 4.1 in the LIA group. During movement, scores were 1.4 and 4.1 for CFNB, and 6.65 and 6.4 for LIA. Despite CFNB offering superior analgesia, the median hospital stay was longer (5.2 days) compared to the LIA group (3.2 days).Abstract P227 Table 1Summary of the resultsConclusions In conclusion, although CFNB provides better pain control, LIA is associated with a shorter hospital stay. These findings highlight LIA as an effective alternative for postoperative analgesia, supporting early mobilization and discharge within ERAS pathways.