effect of esketamine applied in fiberoptic bronchoscopy on negative postoperative behavioral changes of children

Background: fiberoptic bronchoscopy is currently the most commonly used invasive examination method in clinical practice. objectives: this study aimed to assess the impact of esketamine administration during fiberoptic bronchoscopy on the occurrence of negative postoperative behavioral changes (npobcs) in children. methods: ninety children undergoing fiberoptic bronchoscopy were enrolled and randomly assigned to 3 groups: the control group (group c, n = 30), treatment group 1 (group d1, n = 30), and treatment group 2 (group d2, n = 30). group c received intratracheal surface anesthesia and sevoflurane inhalation, along with an intravenous injection of 5 ml of normal saline. group d1 received intratracheal surface anesthesia and sevoflurane inhalation in addition to an intravenous injection of 0.5 mg/kg of esketamine diluted to 5 ml. group d2 received intratracheal surface anesthesia and sevoflurane inhalation, with an intravenous injection of 0.75 mg/kg of esketamine diluted to 5 ml. results: the incidence of npobcs was lower in groups d1 and d2 compared to group c at 1, 7, 14, and 30 days after the examination (p < 0.05). the pediatric anesthesia emergence delirium (paed) scores were lower in groups d1 and d2 than in group c, with group d2 scoring lower than group d1 (p < 0.05). groups d1 and d2 had a longer time to awaken than group c (p < 0.05), with group d2 having a longer time than group d1. the face, legs, activity, cry, and consolability (flacc) scores in groups d1 and d2 were significantly lower than in group c, and group d2 had a lower score than group d1 (p < 0.05). the incidence of adverse reactions was lower in groups d1 and d2 compared to group c, and the rate was even lower in group d2 than in group d1 (p < 0.05). conclusions: administration of esketamine at a dose of 0.75 mg/kg may yield better clinical outcomes.