Abstract:Esketamine is the S-enantiomer of racemic ketamine, which has a similar pharmacological mechanism to ketamine. Esketamine has the advantages of fast onset, fast metabolism, little impact on circulatory and respiratory functions, and strong sedative and analgesic effects. Therefore, esketamine is widely used in multidisciplinary and field areas such as psychiatric disorders, perioperative anesthesia, first aid and critical illness increasingly. This article reviews the pharmacological characteristics, mechanism of action, clinical application status and adverse reactions of esketamine, which aims to provide a reference for application and research.