Objective To study the effect and safety of pulmonary protective ventilation combined with intravenous inhalational anesthesia in pediatric electronic cochlear (CI) implantation.Methods Eighty children with severe or very severe sensorineural hearing loss (SNHL) who received CI implantation in the Sixth Medical Center of Chinese PLA General Hospital from October 2019 to October 2021 were selected as the research objects, and they were divided into the control group and the observation group by random number table method, with 40 cases in each group. Both groups were given intravenous inhalation combined anesthesia, the control group with conventional ventilation strategy and the observation group with lung protective ventilation strategy. The hemodynamic indexes before (T₀) and 30 min after (T₁) the ventilation strategy and the adverse reactions after anesthesia were compared between the two groups.Results At T₀, there were no significant differences in HR, MAP and SPO₂ between the two groups. At T₁, HR, MAP and SPO₂ in the two groups decreased, and the indexes of the observation group was lower than those of the control group (P<0.05). After treatment, MDA level [(6.21±0.19) μmol/L] in the observation group was significantly lower than that in the control group. SOD level [(90.77±11.54) U/L] was significantly higher than that of control group (P<0.05). The rate of the adverse reactions in the observation group (7.50%) was lower than that in the control group (27.50%)(P<0.05).Conclusions Pulmonary protective ventilation combined with intravenous inhalation anesthesia is safe and reliable, which can maintain hemodynamic stability during CI implantation in children, reduce patients’ stress response, and reduce the occurrence of adverse reactions after anesthesia recovery.