Abstract: Objective To investigate the effects of esketamine combined with propofol anesthesia on postoperative recovery and delirium in patients undergoing laparoscopic cholecystectomy. Methods A total of 92 patients who underwent laparoscopic cholecystectomy from June 2022 to June 2024 were selected and randomly divided into two groups using a computerized random table, with 46 cases in each group： a control group （odd numbers） and an observation group （even numbers）. The control group received sufentanil combined with propofol anesthesia, while the observation group received esketamine combined with propofol anesthesia. The study compared and analyzed vital signs （mean arterial pressure and heart rate）, postoperative recovery time （postoperatuve awakening time, extubation time, and orientation recovery time）, postoperative pain scores （by visual analog scale）, and the incidence of postoperative delirium between the two groups. Results After anesthesia induction, at tracheal intubation, and at tracheal extubation, the vital signs of the observation group were higher than those of the control group （P<0.05）. The postoperative recovery time of the observation group was shorter than that of the control group （P<0.05）. At 0.5, 2, 6, 12, and 24 h postoperatively, the pain scores （VAS scores） of the observation group were lower than those of the control group （P<0.05）. The incidence of postoperative delirium in the observation group was lower than that in the control group （P<0.05）. Conclusion The use of esketamine combined with propofol anesthesia during laparoscopic cholecystectomy can stabilize vital signs, shorten postoperative recovery time, reduce postoperative pain symptoms, and lower the incidence of postoperative delirium.

Key words: Laparoscopic cholecystectomy, Esketamine, Propofol, Sufentanil, Delirium