This chapter discusses anaesthesia in ENT, where preanaesthetic medication or premedication refers to the administration of drugs before induction and maintenance of anaesthesia. Aims of premedication are to allay fear, anxiety and tension, to reduce salivary secretions and secretions of respiratory tract, to depress unwanted vagal reflex activities, to potentiate the anaesthetic drugs, and to reduce the undesirable effects of anaesthetics. Various forms of anaesthesia used in ENT include no anaesthesia, local anaesthesia and general anaesthesia. Local anaesthetics produce reversible block of impulse transmission through nerve by blocking sodium ion inflow through membrane, which is necessary for conduction of an electric effect. Local anaesthetics when used in proper dose have minimum general systemic effects. Local anaesthetics may be used as sprays, nasal packs, infiltration or by injection.