Conclusions
desaturation, hypotension
EVENTS
This multicenter randomized clinical trial provides compelling evidence that the addition of low-dose esketamine to propofol-based sedation significantly reduces the incidence of composite desaturation and hypotension events during same-visit bidirectional endoscopy. Moreover, the use of esketamine led to a noteworthy decrease in propofol requirements for these procedures while causing no safety concerns. On the basis of these findings, the incorporation of esketamine as an adjuvant to propofol sedation is strongly supported for patients undergoing same-visit bidirectional endoscopy.