【Abstract】 Objective To investigate the effect of anisodamine injection at the Zusanli acupoint on the postoperative quality of early recovery in patients undergoing laparoscopic sleeve gastrectomy. Methods A total of 117 patients who underwent elective laparoscopic sleeve gastrectomy were selected. According to the random number table method, they were divided into three groups (n=39): a blank control group (group C), a group with normal saline injection at the Zusanli acupoint (group S), and a group with scopolamine injection at the Zusanli acupoints (group A). Group C did not receive any special interventions, group S was injected with normal saline at each Zusanli acupoint on both sides, group A was injected with anisodamine sodium chloride solution at each Zusanli acupoint on both sides. Their general information were recorded; their 40‑item Quality of Recovery Scale (QoR‑40) scores (including five dimensions: physical comfort, emotional state, self‑care, psychological support and pain perception) were recorded on preoperative day 1 (D0) and postoperative day 1 (D1), postoperative day 3 (D3), and postoperative day 7 (D7). After anesthesia induction (T0) and on postoperative 24 h (T1), their venous blood samples were collected, the levels of plasma interleukin‑6 (IL‑6), substance P (SP), and motilin (MTL) were measured by enzyme‑linked immunosorbent assay (ELISA). The time to extubation, the length of post‑anesthesia care unit (PACU) stay, the incidences of adverse events (hiccup, respiratory depression, dizziness, urinary retention, and postoperative bleeding), Numerical Rating Scale (NRS) score at postoperative 24 h, the consumption of analgesic dezocine on postoperative day 1, the incidence of postoperative nausea and vomiting (PONV), the time to first postoperative off‑bed activity, the time to first postoperative anal exhaust, and the length of hospitalization stay were recorded. Results There was no statistical difference in general information among the three groups (P>0.05). On D1, group A showed decreases in QoR⁃40 total score, emotional state, self‑care ability, and pain perception scores (all P<0.05), while group S and group C presented decreases in QoR⁃40 total score, physical comfort, emotional state, self‑care ability, and pain perception scores (all P<0.05), compared with those on D0. On D3, group A showed decreases in QoR⁃40 total score and pain perception scores (all P<0.05), while group S and group C presented decreases in QoR⁃40 total scores, physical comfort, and pain perception scores (all P<0.05), compared with those on D0. On D7, QoR⁃40 total scores decreased in group S and group C (all P<0.05), while pain perception scores decreased in group C (P<0.05). Compared with group C, group A showed increases in QoR⁃40 total scores and physical comfort scores on D1 and D3 (all P<0.05), and increases in pain perception scores on D1, D3, and D7 (all P<0.05), while group S showed increased QoR⁃40 total score on D1 (P<0.05). Compared with group S, group A presented increased QoR⁃40 total score on D1 (P<0.05). Compared with those on D0, there was no statistical difference in psychological support among the three groups on D1 (all P>0.05); there was no statistical difference in emotional state, self‑care ability and psychological support among the three groups on D3 (all P>0.05); and there was no statistical difference in physical comfort, emotional state, self‑care ability and psychological support among the three groups on D7 (all P>0.05). Compared with group C, the differences in QoR ⁃40 total score and physical comfort were not statistically significant on D0 and D7 for group A and group S (all P>0.05), and the differences in emotional state, self‑care ability and psychological support were not statistically significant for groups A and S (all P>0.05). Compared with group S, the differences in physical comfort, emotional state, self‑care ability, psychological support and pain perception of patients in group A on D0, D1, D3 and D7 were not statistically significant (all P>0.05). There was no statistical difference as to the above mentioned three indicators at T0 (all P>0.05). The three groups demonstrated obviously increased plasma IL‑6 and SP levels at T1, compared with those at T0; MTL levels were obviously reduced at T0 (P<0.05). There was no statistical difference in SP among the three groups at T1 (all P>0.05); group A showed lower IL‑6 levels than group C (P>0.05); group A demonstrated remarkably higher MTL levels than group S and group C (all P>0.05), group S presented higher MTL levels than group C. No statistical difference was seen among the three groups in time to extubation, the length of PACU stay, the incidences of adverse events, time to first postoperative off‑bed activity and the length of hospitalization stay (all P>0.05). Postoperative 24 h NRS scores in group A were lower than those in group S and group C (both P<0.05), and postoperative 24 h NRS scores in group S were lower than those in group C (P<0.05). Compared with group C, the consumption of diazoxide on postoperative day 1 was lower, the PONV scores were lower, and the time to first postoperative anal exhaust was shorter in group A (all P<0.05). Conclusions Zusanli acupoint injection of anisodamine can reduce the level of inflammation in patients undergoing laparoscopic sleeve gastrectomy, promote the recovery of gastrointestinal function, relieve postoperative pain and nausea and vomiting, and improve the postoperative quality of early recovery.