Objective To evaluate the different anesthesia on coagulation function in knee replacement patients during the perioperative period using thrombelastography, to provide evidence for clinical anesthesia. Methods A total of 188 cases from December 2013 to September 2015 in our hospital of single knee replacement were studied and they were randomly divided into two groups, each of 94 cases. The control group was administered with general anesthesia, the observation group was administered with nerve block anesthesia, the coagulation time(k), thromboplastin generation time (r), the maximum value of thrombosis (MA), the solidification angle (α), a comprehensive coagulation index (CI) and LY30 were measured in the test. Results Compared with pre-surgery and surgery, the r, k decreased significantly, meanwhile α, MA, CI and LY30 in the general anesthesia group were significantly increased, the difference was statistically significant (P = 0.003), and LY30 in the nerve block anesthesia group was rised significantly, the difference was statistically significant (P = 0.023). when the parameters after surgery were compared in the two group, the r of nerve block anesthesia group was significantly higher, while the α, MA, LY30 and CI were lower than the general anesthesia group, the difference was statistically significant (P = 0.006), the k value of the observation group also had increased, but the difference was not statistically significant (P = 0.086). The ratio of postoperative deep vein thrombosis in the control group (DVT) was 10.6% and the proportion of the observation group DVT was 0%, difference was statistically ignificant (P = 0.030). Conclusions The coagulation after surgery in patients is significant changed where general anesthesia has significantly promote clotting effect, and compared to before, nerve block anesthesia can reverse this effect blood clotting, and lower proportion of DVT.