Abstract:Objective To analyze the application value of aerosol inhalation of esketamine in patients undergoing thoracoscopic radical resection of lung cancer, evaluate its effect on postoperative sore throat (POST), and provide a reference for the clinical prevention and treatment of POST. Methods A total of 75 patients with non-small cell lung cancer (NSCLC) who underwent elective thoracoscopic radical resection of lung cancer at Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine from [August 2022 to August 2024 were selected as the research subjects. They were divided into two groups using a random number table method: the aerosol inhalation group (n=39) received aerosol inhalation of 5 mL esketamine suspension 1 mL esketamine injection (2 mL∶50 mg) + 4 mL normal saline]before anesthesia induction, and the normal saline group (n=36) received aerosol inhalation of 5 mL normal saline before anesthesia induction. The heart rate and mean tracheal intubation (T1), immediately after intubation (T2), 5 min after intubation (T3)], as well as blood glucose and blood lactate levels at T0, T1, and T2 were compared between the two groups. The incidence and duration of POST within 24 h after surgery, the degree of throat pain [Visual Analogue Scale (VAS)], and the incidence of adverse reactions during anesthesia induction were also compared between the two groups. Results At T2 and T3, heart rate and MAP in the aerosol inhalation group were lower than those in the normal saline group (P<0.05). At T2, the level of blood lactate in the aerosol inhalation group was lower than that in the normal saline group (P<0.05). There was no statistically significant difference in blood glucose levels between the two groups at each time point (P>0.05). Compared with the normal saline group, the aerosol inhalation group had a lower incidence of POST (15.38% vs 38.89%, χ²=5.288, P= 0.021), shorter duration of POST [ (9.67±2.73) h vs (13.43±3.48) h, t=2.344, P=0.031], and lower throat VAS score [ (2.83±0.75) points vs (4.64±1.69) points, t=3.310, P=0.004]within 24 h after surgery (P<0.05). During anesthesia induction, the total incidence of adverse reactions in the nebulized inhalation group was lower than that in the normal saline group (7.69% vs 25.00%, χ²=4.172, P=0.041). Conclusion Aerosol inhalation of esketamine can alleviate the cardiovascular response during peri-tracheal intubation, improve tissue perfusion, reduce the incidence of POST, and decrease adverse reactions during anesthesia induction in patients undergoing thoracoscopic radical resection of lung cancer.