Research Progress of Esketamine in Painless Endoscopy

In order to relieve patients' anxiety and pain during operation, reduce postoperative complications, analgesia and sedation techniques are widely used in endoscopic therapy.Esketamine is an anesthetic drug with analgesic effects, primarily through non-competitive inhibition of N-methyl-D-aspartate (NMDA) receptors.Compared with ketamine, it has the advantages of a stronger analgesic effect, faster and more controllable elimination in the body, fewer mental adverse reactions, and a more significant neuroprotective effect.Because of its strong analgesic effect, non-inhibitory effect on respiration under subanesthetic dose, stable circulation, short recovery time, and improvement of postoperative cognitive function, it has become an important drug in painless endoscopic anesthesia.However, due to esketamine's dose-dependent sexual side effects, the increase in respiratory secretions, psychosis symptoms, nausea, vomiting and vertigo, and other adverse reactions should not be ignored.This article reviews the clinical effect, drug usage, and dosage of esketamine in gastroenteroscopy, fiber bronchoscopy, and hysteroscopy, and the clinical application of special populations, which provides a reference for clinical practice.