Objective To explore the clinical application of depth of anesthesia index (AI) based on electroencephalograhpy information sample entropy in pediatric patients who underwent tonsillectomy and adenoidectomy. Methods A total of 124 children aged 3-10 years who underwent tonsil adenoidectomy were admitted to this study. According to random number table method, they were divided into experimental group (group E) and control group (group C), with 62 cases in each group. Both groups received total intravenous anesthesia with propofol and remifentanil. Group E adjusted the depth of anesthesia according to the AI value to maintain the index between 40-60, group C adjusted the depth of anesthesia based on the change in blood pressure and heart rate. The changes in mean arterial pressure (MAP), heart rate, and AI were monitored at the following time points: entering the operating room (T1), before induction (T2), before intubation (T3), 1 min after intubation (T4), 3 min after intubation (T5), 5 min after intubation (T6), at the beginning of surgery (T7), immediately after tonsils removed (T8), immediately after adenoidectomy (T9), at the end of the surgery (T10), upon recovery from anesthesia (T11), and tracheal extubation (T12). Besides, time to recovery from anesthesia, extubation time, total doses of propofol and remifentanil, the Pediatric Anesthesia Emergence Delirium (PAED) scores at 30 min and 2 h after the operation, and the incidences of postoperative complications were also monitored in the two groups. Results The heart rate, MAP, and AI in group E were higher than those in group C during T7‒T10 (P<0.05), the time to recovery from anesthesia and extubation time of group E were shortened (P<0.05), and the dose of propofol was lower in group E as compared to that of group C (P<0.05). There was no significant difference in postoperative complications, and PAED scores between the two groups 30 min and 2 h after the operation (P>0.05). Conclusions AI monitor helps reduce the amount of propofol usage in intravenous anesthesia and shortens the recovery time from anesthesia and extubation time. Thus, it can be safely used in children.