With the development of ENT theory and surgical techniques, the original tonsil squeezing and adenoids scraping have been replaced by tonsil stripping and excision, radiofrequency ablation, pharyngoplasty and endoscopic adenoids aspiration, and radiofrequency ablation, which have made significant progress both in terms of surgical results and trauma to the pediatric population. Of course, the corresponding anesthesia method also changed from the earliest no anesthesia to local anesthesia to general anesthesia. Many parents may not be aware of this and may think that pediatric tonsil and adenoid surgery requires general anesthesia. Some parents have fear and disgust when it comes to general anesthesia, and some even prefer to give up the surgery because they worry that general anesthesia will make their children stupid, and continue to let their children suffer from snoring, breath-holding and lack of oxygen during sleep. In the following, we will introduce in detail the anesthesia method, anesthesia medication, postoperative analgesia and the misconceptions about anesthesia. I. Anesthesia methods Nowadays, general anesthesia is used for pediatric tonsil and adenoid surgery, which is not a way to kill a chicken with a cow, but rather a way to ensure maximum safety of the operated child, and thus has become a common method used worldwide today. In contrast to the previous no-anesthesia to local anesthesia, the child can clearly feel the pain and fear of surgery, thus causing psychological and physiological trauma to the child and leaving a shadow, which in some cases remains until adulthood. At the same time, no anesthesia and local anesthesia can cause residual tonsils and adenoids after surgery due to the child’s inability to cooperate well, and sometimes cause damage to the adjacent tissues. The general anesthesia currently used for surgery should be called intravenous inhalation complex anesthesia (referred to as static inhalation complex anesthesia), which literally includes two types of anesthesia, such as intravenous anesthesia and inhalation anesthesia. The site of pediatric tonsil and adenoid surgery is special, and the trachea and esophagus are open here. The small amount of bleeding during the surgical operation, the continuous secretion of saliva and the clear water for wound rinsing can flow into the trachea and cause misaspiration and asphyxia. Tracheal intubation after anesthesia and before surgery is of great importance to ensure oxygen supply to the child and prevent intraoperative complications of aspiration. The combined use of intravenous anesthesia and inhalation anesthesia at the same time can make the anesthetic effect more complete and make the amount of each drug used decrease, thus reducing the side effects caused by anesthetic drugs and improving the safety of anesthesia. The main side effects of anesthetic drugs are respiratory depression, nausea and vomiting, and allergy. The risk has been greatly reduced because the endotracheal intubation that had been performed previously ensured the oxygen supply to the child. Nausea and vomiting are the most common side effects of anesthetic drugs and vary greatly from child to child, with some children experiencing them shortly after administration and others continuing until the postoperative awakening period. In addition to causing distress to the child, nausea and vomiting may also cause asphyxia due to aspiration of vomitus into the trachea as a result of suppressed protective reflexes in children under anesthesia and recovering from anesthesia. If vomiting occurs after anesthesia, the anesthesiologist will use a suction device to remove the vomit from the mouth, and if the symptoms are severe, antiemetic medication will be given. Allergy is also a common side effect of anesthesia drugs, which will generally disappear on its own after metabolizing the drugs and will not leave any after-effects. Postoperative analgesia The wounds of tonsils and adenoids are open, and the pharynx is the part that must be passed for eating, so postoperative pain is inevitable. Two drugs can be used for analgesia of pharyngeal trauma: NSAIDs and tramadol. NSAIDs produce analgesia by inhibiting the formation of nociceptive substances at the wound site, while tramadol produces analgesia by inhibiting nociceptive receptors in the brain and spinal cord area. The side effects of NSAIDs are mainly bleeding. In contrast, the side effect of tramadol is mainly nausea and vomiting. The appropriate medication for postoperative analgesia should be chosen for each child’s specific situation.