Objective　To investigate the effect of perioperative intravenous lidocaine infusion on postoperative early recovery quality in patients undergoing upper airway surgery. Methods　One hundred and twenty patients undergoing upper airway surgery were divided into two groups according to a random number table: a lidocaine group (group L) and a control group (group C), with 60 patients in each group. Group L was administered with 2.0 mg/kg lidocaine over 10 min before induction of anesthesia, followed by intravenous infusion at 2 mg·kg−1·h−1 until the end of surgery. Group C was given the same volume of normal saline. The 40‑item Quality of Recovery Score (QoR‑40 score) as well as the consumption of sufentanil and remifentanil during surgery and the incidence of postoperative nausea and vomiting (PONV) were recorded before surgery (T0), 24 h after surgery (T1) and 48 h after surgery (T2). Results　The global QoR‑40 scores and the scores for physical comfort, physical independence, psychological support and pain at T1 and T2 in two groups as well as the score for emotional state at T1 in group C were significantly lower than those at T0 (P<0.05). Compared with those in group C, the global QoR‑40 scores and the scores for physical comfort, emotional state, and pain significantly increased in group L at T1 and T2 (P<0.05), where the score for physical independence in group L was superior to that in group C at T1 (P<0.05). Compared with those in group C, the dosage of remifentanil used during surgery and the incidence of PONV within 48 h in group L significantly reduced (P<0.05). Conclusions　Perioperative intravenous lidocaine infusion can improve QoR‑40 scores in patients two days after upper airway surgery, reduce the dosage of opioids and the incidence of PONV and improve postoperative early recovery quality.