Effect of the Preoperative Application of Esketamine on Stress Indicators in Paediatric Patients Undergoing Bronchoalveolar Lavage Under General Anaesthesia

<b>Aims/Background</b> To explore the effect of the preoperative administration of esketamine on stress indices in paediatric patients undergoing bronchoalveolar lavage (BAL) under general anaesthesia. <b>Methods</b> A retrospective cohort study was conducted to collect clinical data from children undergoing BAL under general anaesthesia in Tianjin Hospital of Tianjin University between February 2021 and January 2024. The patients were divided into two groups: the reference group (taking no preoperative medications) and the study group (receiving preoperative esketamine). The baseline variables of the two groups were balanced using the 1:1 nearest neighbour matching method of propensity score matching (PSM), and the outcome indicators of the matched cohorts were compared. <b>Results</b> A total of 168 patients were included, including 86 in the reference group and 82 in the study group. After PSM, 46 cases in each group were successfully matched. Results showed that all postoperative stress indicators in the study group were significantly lower than those in the reference group (<i>p</i> < 0.001). The Paediatric Anaesthesia Emergence Delirium (PAED) scores and Face, Legs, Arms, Crying, Consolability (FLACC) scale scores of the children in the study group were significantly lower than those in the reference group (<i>p</i> < 0.01). There was no significant difference in the overall incidence of perioperative adverse reactions between the two groups (<i>p</i> > 0.05). <b>Conclusion</b> The preoperative application of esketamine can reduce the stress response in paediatric patients undergoing BAL under general anaesthesia. This effect is beneficial for enhancing the outcome of surgical treatment.