{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T18:35:35Z","timestamp":1793212535805,"version":"4.5.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The neutrophil-to-lymphocyte ratio (NLR) is one of the prognostic factors reflecting the balance between systemic inflammation and immunity in the body. This study aimed to compare the impact of laryngoscopy on hemodynamic status and NLR after induction of anesthesia with etomidate, propofol, and ketamine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This triple-blind, prospective clinical trial was conducted in 2022 on 90 laryngoscopy candidates. The patients were assigned to three groups of 30. For anesthesia, 0.3 mg\/kg of etomidate in the first group, 2.5 mg\/kg propofol in the second group, and 2 mg\/kg of ketamine in the third group were injected slowly, and the patient underwent ventilation with 100% oxygen for at least 3 minutes; then, laryngoscopy, followed by intubation, was carried out. Blood samples were collected before intubation, immediately after recovery, 20 minutes later, 1 hour later, and at the end of recovery and transmitted to the laboratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Changes in systolic blood pressure (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.02), diastolic blood pressure (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01), and mean arterial pressure were significantly higher in the propofol group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.01). The heart rate (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.56) and oxygen saturation level (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.62) were similar between the three groups. Changes in the mean lymphocyte (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) as well as changes in the NLR (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) were significantly higher in the ketamine group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Changes in the neutrophil mean values showed no significant differences (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.24) as the incidence of complications, such as nausea, vomiting, and headache in the three groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The present study indicated that etomidate had hemodynamic stability and reduced changes in the mean values of lymphocyte, neutrophil, and NLR compared to ketamine and propofol.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/abr.abr_310_24","type":"journal-article","created":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T18:00:25Z","timestamp":1793210425000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparing the Impact of Laryngoscopy on 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