Objective To investigate the general anesthesia combined with fascia iliaca compartment block on postoperative delirium (POD) and analgesia after total hip arthroplasty. Method From January 2015 to January 2019, 480 patients with THA in our hospital, aged 45-75 years, were divided into control group (general anesthesia) and experimental group (general anesthesia combined with fascia iliaca compartment block), 252 cases and 228 cases, respectively. The anesthesia index, incidence of POD and DRS score, VAS score and lower limb muscle strength were compared between the two groups. Result There was no significant difference in he anesthesia index (anesthesia time, operation time, intraoperative bleeding volume, HR, MAP, SpO2) between the two groups (P > 0.05). At 24 hours and 48 hours after operation, the CAM-ICU score and DRS score, the times of pressing analgesic pump, cumulative dosage of sufentanil and VAS score of the control group were significantly higher than those of the experimental group (P < 0.05). In addition, there was no significant difference in muscle strength of quadriceps femoris and iliopsoas between the two groups (P > 0.05).Conclusion Ultrasound-guided fascia iliaca compartment block combined with general anesthesia could reduce the incidence of POD in THA patients, significantly alleviate the pain after operation, facilitate the rapid recovery of patients and shorten the hospital time.