Background
painless, upper gastrointestinal endoscopy, hypotension, pain
RESPIRATORY DEPRESSION, COLLAPSE
Unlike adults, children can be physically or psychologically traumatized during upper gastrointestinal endoscopy in an awake state. With the widespread development of comfort medicine, most pediatric gastroscopies are completed under sedation. Propofol is commonly used for procedural sedation for pediatric gastroscopy. However, the application of propofol alone for painless gastroscopy will enhance the dosage and side effects such as injection pain, respiratory depression, delayed recovery time, hypotension, and upper airway collapse [Esketamine is the dextro-monomer of ketamine and the noncompetitive N-methyl-D-aspartate receptor antagonist. Esketamine has the advantages of rapid onset, analgesia, hypnosis, and mild respiratory depression. In recent years, esketamine was found to be exceptional in combination with propofol for procedural sedation during gastroscopy [We designed a sequential enrollment study using the Dixon and Massey up-and-down method [