Cochlear implants are expensive surgeries. It was expected that by the end of the year 2021 about 80,000 cochlear implants will be shipped worldwide. Alone in India 500 cochlear implants are placed in a year. Patients for these procedures are mostly young children with prelingual deafness. They often pose challenges like anxiety, post operative nausea and vomiting, haemorrhage and CSF leak or flap necrosis. Parent child separation is another concern in a deaf paediatric patient. A meticulous anaesthetic management provides comfortable induction and a stable intra operative hemodynamics to give favourable outcomes.