Introduction: Effective postoperative analgesia is essential for early mobilization, rehabilitation, and patient satisfaction following total knee replacement (TKR). While continuous epidural analgesia remains a traditional technique, peripheral nerve blocks such as the continuous femoral triangle block and continuous adductor canal block have emerged as promising alternatives that may offer comparable analgesia with fewer side effects. Aim: To compare the efficacy, safety, opioid consumption, and functional outcomes of continuous epidural analgesia (CE), ultrasound-guided continuous femoral triangle block (CF), and continuous adductor canal block (AC) for postoperative analgesia after TKR. Materials and Methods: Sixty patients undergoing primary TKR were randomized into three equal groups: CE (n=20), CF (n=20), and AC (n=20). Baseline demographics, intraoperative variables, postoperative pain scores (VAS), opioid requirements, side effects, and functional outcomes were recorded and statistically analyzed. Results: Baseline characteristics and intraoperative variables were comparable among groups (p>0.05). CE provided marginally lower early pain scores, but this advantage diminished by 24–48 hours. Opioid consumption was significantly higher in the CF group, while the AC group required the least opioids (p<0.01). CE was associated with the highest incidence of hypotension (30%) and motor block (35%). Functional outcomes were superior in the AC group, with earlier ambulation (20 ± 4 hours) and lower quadriceps weakness (15%) (p<0.001). Patient satisfaction was highest in CE and AC groups, with clinically acceptable scores in all. Conclusion: All three modalities provided effective analgesia after TKR; however, the adductor canal block demonstrated the best balance between analgesia, safety, preserved motor function, and early mobilization. It appears to be a preferred option for enhanced recovery after TKR.