One hundred thirty-four patients undergoing elective primary total hip arthroplasty under spinal anesthesia were randomized to receive either an ultrasound-guided suprainguinal fascia iliaca compartment block with 0.5% ropivacaine (n=66) or a sham block with normal saline (n=67). The primary outcome was opioid consumption in the first 24 hours postoperatively. Secondary outcomes included pain scores at 4, 8, 12, 16, 20, and 24 hours postoperatively, opioid-related side effects (nausea, vomiting, pruritus), ability to perform physiotherapy on postoperative day one, and presence of physiotherapist-assessed quadriceps weakness. Overall, the study found no significant difference in opioid consumption between groups or in secondary outcomes, including pain scores, opioid-related side effects, or ability to perform physiotherapy. These findings suggest that adding ultrasound-guided suprainguinal fascia iliaca block to a multimodal analgesic regimen does not provide a significant opioid-sparing benefit after total hip arthroplasty.