Objective To observe the early analgesic effect of pericapsular nerve group block (PNGB) on elderly patients with hip fractures during hospitalization before surgery, so as to provide evidence for perioperative analgesic optimization. Methods A total of 50 patients who were scheduled for unilateral hip replacement were divided into two groups, according to the random number table method (n=25): a PNGB group and a fascia iliaca compartment block (FICB) group. The following data were recorded: general condition; resting Visual Analogue Scale (VAS) scores before nerve block analgesia (T0), resting and motion VAS scores 10 min (T1), 20 min (T2), 30 min (T3) and 24 h (T4) after nerve block analgesia; the angle of passive hip flexion at T1 to T4 and adverse reactions. Results The resting VAS scores at T1 to T4 were lower than those at T0 (P<0.05). Compared with the FICB group, the PNGB group presented reduced resting and exercise VAS scores at T1 to T4 (P<0.05), and increased angle of passive hip flexion at T1 to T3 (P<0.05). Conclusions PNGB can quickly relieve early dynamic pain for patients with hip fractures and optimize the analgesia mode.