Objective To investigate the effects of different anesthesia induction drugs on hemodynamic stability and postoperative recovery in elderly patients undergoing laparoscopic surgery. Methods 64 patients with laparoscopic cholecystectomy (LC) in our hospital from January 2022 to February 2024 were selected and divided into group A (32 cases) and group B (32 cases) by random double-blind method. Both groups were given remazolam + Sufentanil + remifentanil + cisatracurium anesthesia induction, group A plus propofol anesthesia induction, group B plus etomidate anesthesia induction. The surgical conditions and heart rate, systolic blood pressure, diastolic blood pressure, cortisol (Cor) and norepinephrine (NE) of the two groups before induction (T0), after induction (T1), intubation (T2), skin resection (T3), and 5min after extubation (T4) were statistically compared and compared. The postoperative recovery questionnaire (QoR 40) was used to evaluate the quality of recovery 24h after surgery. Visual analog scale (VAS) score, recovery time and recovery time of orientation were compared between the two groups. Results There were no significant differences in operation time, anesthesia onset time, blood loss, recovery time and orientation recovery time between the two groups (P > 0.05). The intraoperative dosage of propofol and remifentanil in group A was lower than that in group B (P < 0.05). The fluctuation range of heart rate, systolic blood pressure, diastolic blood pressure, Cor and Ne levels in group A was lower than that in group B during T1-T3 (P < 0.05). The quality of recovery 24h after operation in group A was higher than that in group B, and the VAS score at recovery was lower than that in group B (P < 0.05). Conclusion During laparoscopy, anesthesia induced sedation and analgesia with propofol + remazolam + Sufentanil + remifentanil + cisatracurium can effectively stabilize the hemodynamics of patients, reduce stress response and promote postoperative recovery.