[Objective] To investigate the Effects of perioperative inflammatory response and insulin resistance in patients undergoing hip arthroplasty with quadratus lumborum compartment fascia iliaca block. [Methods] Sixty patients undergoing unilateral hip arthroplasty were randomly divided into two groups: general anesthesia group (group C) and quadratus lumborum compartment fascia iliaca block group (group L) with 30 cases in each group by random numerical table method. The patients with quadratus lumborum compartment fascia iliaca block received quadratus lumborum compartment fascia iliaca block before general anesthesia. Blood samples of peripheral venous were collected at 10 min before anesthesia (T0), immediately after operation (T1), 24 hours after operation (T2) and 72 hours after operation (T3). The levels of serum inflammatory mediator C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor α (TNF- α) were recorded, and the concentrations of blood glucose and insulin were measured. CRP, IL-6, TNF-αwere measured by enzyme-linked immunosorbent assay (ELISA). The insulin resistance index was evaluated using a steady-state model. Perioperative arrhythmia of lead II electrocardiogram, the dosage of remifentanil and postoperative nausea and vomiting were recorded. [Results] Compared with T0, the levels of CRP, IL-6, TNF- α and IRI in group C and group L increased at T1 and T2 (P<0.05). Compared with group C, the levels of CRP, IL-6, TNF-α and IRI in group L were lower (P<0.05). Compared with group C, the incidence of postoperative adverse reactions in group L was lower and the amount of remifentanil during operation was lower (P<0.05). [Conclusion] Quadratus lumborum compartment fascia iliaca block could reduce perioperative inflammatory response in patients with total hip arthroplasty, and improve insulin resistance.