Objective To explore the effectiveness of esketamine nebulized inhalation in pediatric bronchoalveolar lavage under general anesthesia.Methods 68 cases of children who were to undergo elective bronchoalveolar lavage in our hospital from August 2023 to April 2024 were selected and divided into ketamine nebulization group(Group K)and saline nebulization group(Group N)according to the random number table method.The choking scores and duration at the time after awakening from anesthesia, heart rate(HR),blood pressure(BP),blood oxygen saturation(SpO2)at each time point of basal (T0),after laryngeal mask placement(T1),ciliophora over the vocal folds(T2),at the time of alveolar lavage(T3)and after alveolar lavage(T4),airway pressure(Paw)at T1~4,fentanyl dosage,and the awakening and extubation time,the occurrence of postoperative nausea and vomiting, hypoxaemia, laryngospasm, and agitation during awakening is a potential complication.Results The choking score and duration of patients in group K were lower than those in group N at the time of anesthesia induction and after anesthesia awakening,the airway pressure (Paw) at T1~4,fentanyl dosage,awakening time of group K were smaller than those of group N.The differences in HR,blood BP and SpO2 changes between T0~5 of the two groups were not statistically significant.The statistical analysis revealed that there was no significant difference in the occurrence of nausea and vomiting, hypoxaemia, laryngospasm, and agitation during awakening between the two groups.Conclusion Esketamine nebulized inhalation can be effectively used for pediatric bronchoalveolar lavage,reduce the degree of choking and airway irritation,reduce fentanyl dosage, and shorten the time of awakening.