【Objective】 ObjectiveTo explore whether nerve block can be decreased by providing effective analgesic chest surgery postoperative delirium (POD).Methods PubMed, Embase, Cochrane Library, Web of science and Scopus databases were searched by computer from December 01, 2023.Using nerve block in the chest surgery analgesia randomized controlled trials, according to whether to accept patients with nerve block will be divided into trial group and control group.The primary outcome was the incidence of postoperative delirium, and the secondary outcome was postoperative pain control and length of stay.Two researchers independently screened literature, extracted data, and evaluated the risk of bias in included studies. Meta-analysis was performed using RevMan 5.4.1 software, and the results were represented by forest maps. GRADEpro system was used to grade the evidence quality of meta-analysis results, and subgroup analysis was used to explore the sources of heterogeneity.Results Ten randomized controlled trials with 1285 participants were included, 643 in the experimental group and 642 in the control group.Meta analysis results show that: compared with control group, experimental group reduction in POD [RR=0.48, 95%CI(0.38, 0.61), P<0.001, I2=0.00%];24h postoperative pain score significantly reduced [SMD=1.95, 95%CI(3.11, 0.78), P= 0.001, I2 = 98%].Length of hospital stay was shortened [MD=-0.69,95%CI(-0.94, -0.44), P<0.001, I2= 45%].Postoperative incidence of nausea and vomiting was decreased [MD=0.47,95%CI(0.23, 0.95), P=0.03, I2= 59%].Conclusion? the nerve block can reduce the chest surgery patients with POD, and effective control of postoperative pain in 24 hours, shorten hospitalization time, reduce the occurrence of postoperative nausea and vomiting.