The proposed combination of low-dose esketamine and remimazolam represents a paradigm shift in pediatric bronchoscopy anesthesia, theoretically harmonizing efficacy and safety through pharmacodynamic synergy.

By capitalizing on esketamine’s airway-protective analgesia and remimazolam’s precision sedation, this regimen addresses the longstanding dichotomy between procedural immobility and physiological preservation in children.

The combination of low-dose esketamine and remimazolam addresses these limitations through complementary mechanisms of action.

Esketamine, the S-enantiomer of ketamine, exhibits potent NMDA receptor antagonism at doses as low as 0.2–0.5 mg/kg, providing subdissociative analgesia while reducing the risk of psychomimetic side effects

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