Abstract： Objective:To investigate the effect of prophylactic use of low-dose esketamine on restlessness during general anesthesia in children undergoing tonsil adenoid surgery.Methods:A random number table method was used to divide 80 children who underwent tonsillectomy in our hospital from January 2022 to July 2023 into two groups,with 40 cases in each group.The control group received traditional general anesthesia,whereas the study group received low-dose esketamine anesthesia.The perioperative indexes,hemodynamic indexes at different time points,and incidence of agitation and delirium during the recovery period were compared between the two groups.Results:Extubation time was shorter in the study group than in the control group(P＜0.05).There were no significant differences in anesthesia and surgical time between the two groups(P＞0.05).At T0 and T4,there were no significant differences in heart rate(HR)and mean arterial pressure(MAP)between the two groups(P＞0.05).At T1 and T2,MAP and HR levels in the study group were higher than those in the control group(P＜0.05).At T3,the MAP levels in the study group were higher than those in the control group(P＜0.05),but there was no statistically significant difference in the HR levels between the two groups(P＞0.05).The incidence of agitation and delirium in the study group was lower than that in the control group(P＜0.05).Conclusion:The prophylactic application of low-dose esketamine in tonsil adenoid surgery can effectively shorten the time of extubation,stabilize intraoperative hemodynamics,and reduce the incidence of agitation and delirium during the recovery period,which is conducive to improving the quality of the recovery period and is worthy of popularization.