Ninety children aged 2 to 7 years undergoing unilateral periacetabular osteotomy for hip dysplasia were randomized to receive either a pericapsular nerve group (PENG) block (n=30), a lumbar erector spinae plane block (ESPB) (n=30), or no block (control, n=30), all under spinal anesthesia. The primary outcome was postoperative pain assessed by FLACC score over 48 hours. Secondary outcomes included pain at multiple time points, total opioid consumption, and stress biomarkers (NLR, PLR). Outcomes were evaluated at 30, 60, 90, 120 minutes, and at 6, 12, 24, and 48 hours postoperatively. Overall, the results showed significantly lower pain scores and opioid use in both block groups compared to controls, with nearly half of the block group patients requiring no opioids. Both block types also significantly reduced NLR and PLR levels, suggesting reduced surgical stress. These findings support incorporating PENG or ESPB into multimodal analgesia for pediatric hip surgery.