Comparing the Impact of Laryngoscopy on Hemodynamic Status and the Neutrophil-To-Lymphocyte Ratio After Induction of Anesthesia With Etomidate, Propofol, and Ketamine Publisher

Summary: Which anesthetic best preserves stability? A comparative study found etomidate caused smaller hemodynamic and blood-cell changes than ketamine or propofol. #Anesthesia #ClinicalResearch

Heidari S M ; Nazemroaya B ; Farhanian P
Source: Advanced Biomedical Research Published:2026

Abstract

Abstract – Background: – 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. Materials and Methods: – 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. Results: – Changes in systolic blood pressure (P = 0.02), diastolic blood pressure (P < 0.01), and mean arterial pressure were significantly higher in the propofol group (P = 0.01). The heart rate (P = 0.56) and oxygen saturation level (P = 0.62) were similar between the three groups. Changes in the mean lymphocyte (P < 0.001) as well as changes in the NLR (P < 0.001) were significantly higher in the ketamine group (P < 0.001). Changes in the neutrophil mean values showed no significant differences (P = 0.24) as the incidence of complications, such as nausea, vomiting, and headache in the three groups. Conclusion: – 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. © 2026 Advanced Biomedical Research