{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:50:37Z","timestamp":1791334237775,"version":"4.3.1"},"reference-count":27,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>This study aimed to evaluate the effect of adrenaline-containing irrigation on visual clarity, surgical efficiency, and perioperative hemodynamic safety during unilateral biportal endoscopic lumbar decompression (UBELD). Adrenaline has previously been successfully used by orthopedic surgeons in arthroscopic surgery, with positive effects on visual clarity observed. Achieving visual clarity in spinal endoscopic surgery is challenging. Improving visual clarity is critical for minimizing complications and achieving successful outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A retrospective comparative study was conducted involving 61 consecutive patients who underwent single-level UBELD. Adrenaline-containing saline irrigation (1 mg\/3 L saline) was administered to 29 patients, while standard saline irrigation was administered to 32 patients. Surgical duration, irrigation volume, visual clarity scores, perioperative hemodynamic parameters, and clinical outcomes were compared between the groups. Visual clarity was independently assessed by two blinded surgeons with unilateral biportal endoscopic experience using a 10-point numeric rating scale. Interrater reliability was evaluated using the intraclass correlation coefficient (ICC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Baseline demographic and clinical characteristics were comparable between groups. The epinephrine group had significantly shorter operative times (mean 58.8 [SD 8.7] vs 71.8 [SD 9.1] minutes, p &lt; 0.001), lower irrigation volume requirements (mean 23.4 [SD 3.0] vs 25.9 [SD 3.6] L, p = 0.003), and higher visual clarity scores (mean 8.2 [SD 1.6] vs 6.8 [SD 1.9], p = 0.002). Interrater reliability in visual clarity assessment was excellent (ICC = 0.92). No significant differences were observed between groups in perioperative mean arterial pressure, heart rate, or postoperative visual analog scale scores. A transient intraoperative hypertensive episode was observed in 1 patient in the epinephrine group, but this resolved after discontinuation of adrenaline irrigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Adrenaline-containing irrigation was associated with improved visual clarity, reduced need for irrigation, and shorter operative duration without causing significant hemodynamic instability during UBELD surgery. Prospective randomized studies are required to confirm the independent effect of adrenaline while controlling for time- and procedure-related confounding factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.7.focus26345","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:03:21Z","timestamp":1790121801000},"page":"E9","source":"Crossref","is-referenced-by-count":0,"title":["Effect of adrenaline-containing irrigation on visual clarity during unilateral biportal endoscopic lumbar decompression: a retrospective comparative study"],"prefix":"10.3171","volume":"61","author":[{"given":"Gardashkhan","family":"Kar\u0131mzada","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Hitit University, \u00c7orum Erol Ol\u00e7ok Training and Research Hospital, \u00c7orum;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet \u0130lker","family":"\u00d6zer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sincan Training and Research Hospital, Ankara;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demet","family":"Evleksiz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hitit University, \u00c7orum Erol Ol\u00e7ok Training and Research Hospital, \u00c7orum;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adem","family":"Do\u011fan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sehitkamil State Hospital, Gaziantep, T\u00fcrkiye;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00f6yal","family":"Mehdiyev","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ege Hospital, Baku, Azerbaijan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cahit","family":"Kural","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Lokman Hekim University, Ankara;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130lker","family":"Solmaz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Private Clinic, Ankara, T\u00fcrkiye; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheol Wung","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Daejeon Woori Hospital, Daejeon, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Clin Neurol Neurosurg","first-page":"106812","article-title":"Resection of intra- and paraventricular malignant brain tumors using fluorescein sodium-guided neuroendoscopic transtubular approach","volume":"207","author":"Kutlay M","year":"2021","unstructured":"Kutlay M, Durmaz MO, K\u0131r\u0131k A,  Resection of intra- and paraventricular malignant brain tumors using fluorescein sodium-guided neuroendoscopic transtubular approach. 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