{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:19:42Z","timestamp":1760059182701,"version":"build-2065373602"},"reference-count":40,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Scientific Research Projects Coordination Unit of Hatay Mustafa Kemal University","award":["20.M.043"],"award-info":[{"award-number":["20.M.043"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Remifentanil and dexmedetomidine are widely used agents for pain management during general anesthesia. Adropin acts as a regulator of endothelial function by affecting nitric oxide bioavailability and various hemodynamic factors, including blood flow, vascular dilatation, and mean arterial pressure. We aimed to evaluate the effects of remifentanil and dexmedetomidine on adropin and eNOS levels and hemodynamic parameters in patients undergoing unilateral single-level lumbar microdiscectomy under controlled hypotension. Methods: This study included 40 patients who underwent lumbar microdiscectomy and were randomly assigned to two groups: 20 patients received remifentanil, and 20 received dexmedetomidine. Hemodynamic parameters, preoperative and postoperative VAS scores, and intraoperative blood loss were recorded. Adropin and eNOS mRNA levels were measured with RT-qPCR at three time points: preoperative (T1), intraoperative (T2), and postoperative (T3). Adropin protein levels were evaluated using ELISA. Results: The remifentanil and dexmedetomidine groups had similar heart rate, arterial pressure, intraoperative blood loss, surgery time, and VAS scores. The extubation time was longer with remifentanil. Adropin mRNA level was higher in remifentanil at all time points. At T2, the eNOS mRNA level was higher in the remifentanil group. In the dexmedetomidine group, adropin mRNA levels decreased at T2 compared to T1. Adropin protein levels were higher in the remifentanil group at T2 and T3. In the dexmedetomidine group, serum adropin levels decreased at T3 compared to those at T1. Preoperative VAS scores in patients receiving both remifentanil and dexmedetomidine were higher than postoperative VAS scores. No significant correlation was observed between VAS scores and adropin levels or between intraoperative blood loss and adropin protein levels. Conclusions: Both drugs demonstrated similar effects on the hemodynamics of the patients, and adropin levels were not associated with the VAS score and intraoperative blood loss. These findings suggest that dexmedetomidine mediates vasodilation through adropin-independent mechanisms, while remifentanil may provide more favorable surgical conditions through adropin in patients undergoing unilateral single-level lumbar microdiscectomy.<\/jats:p>","DOI":"10.3390\/jcm14113711","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T04:49:52Z","timestamp":1748234992000},"page":"3711","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Dexmedetomidine and Remifentanil on Adropin Expression in Unilateral Lumbar Microdiscectomy: A Prospective Active Controlled Randomized Trial Study"],"prefix":"10.3390","volume":"14","author":[{"given":"G\u00fclay","family":"G\u00fclbol-Duran","sequence":"first","affiliation":[{"name":"Department of Medical Biology, Tayfur Ata Sokmen Faculty of Medicine, Hatay Mustafa Kemal University, 31060 Antakya, Hatay, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Senem","family":"Urfal\u0131","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Tayfur Ata Sokmen Faculty of Medicine, Hatay Mustafa Kemal University, 31060 Antakya, Hatay, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2854-6833","authenticated-orcid":false,"given":"Boran","family":"Urfal\u0131","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tayfur Ata Sokmen Faculty of Medicine, Hatay Mustafa Kemal University, 31060 Antakya, Hatay, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1302\/0301-620X.101B4.BJJ-2018-1184.R1","article-title":"Complications, reoperations, readmissions, and length of hospital stay in 34,639 surgical cases of lumbar disc herniation","volume":"101-B","author":"Fjeld","year":"2019","journal-title":"Bone Jt. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"505","DOI":"10.14444\/8249","article-title":"Preoperative Lumbar Epidural Steroid Injection Increases the Risk of a Dural Tear During Minimally Invasive Lumbar Discectomy","volume":"16","author":"Shakya","year":"2022","journal-title":"Int. J. Spine Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.spinee.2013.08.003","article-title":"An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy","volume":"14","author":"Kreiner","year":"2014","journal-title":"Spine J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"C674","DOI":"10.1152\/ajpcell.00318.2022","article-title":"Protective roles of adropin in neurological disease","volume":"324","author":"Gunraj","year":"2023","journal-title":"Am. J. Physiol. Cell Physiol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Shahjouei, S., Ansari, S., Pourmotabbed, T., and Zand, R. (2016). Potential Roles of Adropin in Central Nervous System: Review of Current Literature. Front. Mol. Biosci., 3.","DOI":"10.3389\/fmolb.2016.00025"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1016\/j.cmet.2008.10.011","article-title":"Identification of adropin as a secreted factor linking dietary macronutrient intake with energy homeostasis and lipid metabolism","volume":"8","author":"Kumar","year":"2008","journal-title":"Cell Metab."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/s11010-013-1660-4","article-title":"Expression of adropin in rat brain, cerebellum, kidneys, heart, liver, and pancreas in streptozotocin-induced diabetes","volume":"380","author":"Aydin","year":"2013","journal-title":"Mol. Cell. Biochem."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S185","DOI":"10.1161\/CIRCULATIONAHA.109.931782","article-title":"Adropin is a novel regulator of endothelial function","volume":"122","author":"Lovren","year":"2010","journal-title":"Circulation"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.peptides.2014.03.021","article-title":"Three new players in energy regulation: Preptin, adropin and irisin","volume":"56","author":"Aydin","year":"2014","journal-title":"Peptides"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.1113\/JP277410","article-title":"Vasodilatory function in human skeletal muscle feed arteries with advancing age: The role of adropin","volume":"597","author":"Kwon","year":"2019","journal-title":"J. Physiol."},{"key":"ref_11","first-page":"292","article-title":"Inhaled nitric oxide in adult patients with acute respiratory distress syndrome","volume":"41","year":"2017","journal-title":"Farm. Hosp."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1002\/(SICI)1096-8652(200005)64:1<15::AID-AJH3>3.0.CO;2-P","article-title":"Sequential nitric oxide measurements during the emergency department treatment of acute vasoocclusive sickle cell crisis","volume":"64","author":"Lopez","year":"2000","journal-title":"Am. J. Hematol."},{"key":"ref_13","first-page":"6457","article-title":"Effects of epidural anesthesia combined with dexmedetomidine on blood pressure, sedation, analgesia and serum beta-endorphin levels in patients with hip fractures","volume":"13","author":"Ma","year":"2021","journal-title":"Am. J. Transl. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"133","DOI":"10.2174\/187152806776383116","article-title":"Nitric oxide, aspirin-triggered lipoxins and NO-aspirin in gastric protection","volume":"5","author":"Wallace","year":"2006","journal-title":"Inflamm. Allergy Drug Targets"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1097\/ACO.0000000000000879","article-title":"Soft drugs in anesthesia: Remifentanil as prototype to modern anesthetic drug development","volume":"33","author":"Birgenheier","year":"2020","journal-title":"Curr. Opin. Anaesthesiol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Janipour, M., Bastaninejad, S., Mohebbi, A., Amali, A., Owji, S.H., Jazi, K., Mirali, R.A., and Moshfeghinia, R. (2024). Dexmedetomidine versus remifentanil in nasal surgery: A systematic review and meta-analysis. BMC Anesthesiol., 24.","DOI":"10.1186\/s12871-024-02563-0"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1111\/j.1365-2044.2007.05221.x","article-title":"Remifentanil for general anaesthesia: A systematic review","volume":"62","author":"Komatsu","year":"2007","journal-title":"Anaesthesia"},{"key":"ref_18","first-page":"e79759","article-title":"Comparative Efficacy of Dexmedetomidine and Remifentanil in Reducing Postoperative Pain and Opioid Use: A Systematic Review","volume":"17","author":"Weissman","year":"2025","journal-title":"Cureus"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"323","DOI":"10.4097\/kja.19259","article-title":"Dexmedetomidine: Present and future directions","volume":"72","author":"Lee","year":"2019","journal-title":"Korean J. Anesthesiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1097\/00000542-200008000-00016","article-title":"The effects of increasing plasma concentrations of dexmedetomidine in humans","volume":"93","author":"Ebert","year":"2000","journal-title":"Anesthesiology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1089\/met.2021.0015","article-title":"Correlation of Serum Adropin Levels with Risk Factors of Cardiovascular Disease in Hemodialysis Patients","volume":"19","author":"Liu","year":"2021","journal-title":"Metab. Syndr. Relat. Disord."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1097\/00000542-194105000-00004","article-title":"Grading of patients for surgical procedures","volume":"2","author":"Saklad","year":"1941","journal-title":"Anesthesiology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/0952-8180(94)00001-K","article-title":"The post-anesthesia recovery score revisited","volume":"7","author":"Aldrete","year":"1995","journal-title":"J. Clin. Anesth."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"S66","DOI":"10.1007\/s00586-004-0756-7","article-title":"Controlled hypotension for spinal surgery","volume":"13","author":"Dutton","year":"2004","journal-title":"Eur. Spine J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1016\/S0140-6736(74)90884-8","article-title":"Measurement of pain","volume":"2","author":"Huskisson","year":"1974","journal-title":"Lancet"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1007\/s10067-025-07359-2","article-title":"miR-451a and IL18 can differentiate familial Mediterranean fever patients in attack and remission periods: A prospective cross-sectional study","volume":"44","author":"Terzi","year":"2025","journal-title":"Clin. Rheumatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.metabol.2019.06.005","article-title":"Adropin regulates cardiac energy metabolism and improves cardiac function and efficiency","volume":"98","author":"Altamimi","year":"2019","journal-title":"Metabolism"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Mocnik, M., and Marcun Varda, N. (2022). Current Knowledge of Selected Cardiovascular Biomarkers in Pediatrics: Kidney Injury Molecule-1, Salusin-alpha and -beta, Uromodulin, and Adropin. Children, 9.","DOI":"10.3390\/children9010102"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.2165\/00003495-200767070-00007","article-title":"Controlled hypotension: A guide to drug choice","volume":"67","author":"Degoute","year":"2007","journal-title":"Drugs"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e020641","DOI":"10.1161\/JAHA.120.020641","article-title":"Aerobic Exercise Restores Aging-Associated Reductions in Arterial Adropin Levels and Improves Adropin-Induced Nitric Oxide-Dependent Vasorelaxation","volume":"10","author":"Fujie","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1111\/jocs.16163","article-title":"Effect of postoperative administration of inhaled nitric oxide combined with high-frequency oscillatory ventilation in infants with acute hypoxemic respiratory failure and pulmonary hypertension after congenital heart surgery: A retrospective cohort study","volume":"37","author":"Huang","year":"2022","journal-title":"J. Card. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e66959","DOI":"10.5812\/aapm.66959","article-title":"A Comparative Study of the Amount of Bleeding and Hemodynamic Changes between Dexmedetomidine Infusion and Remifentanil Infusion for Controlled Hypotensive Anesthesia in Lumbar Discopathy Surgery: A Double-Blind, Randomized, Clinical Trial","volume":"8","author":"Javaherforooshzadeh","year":"2018","journal-title":"Anesth. Pain. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1358\/dot.1999.35.3.533844","article-title":"Dexmedetomidine","volume":"35","author":"Mantz","year":"1999","journal-title":"Drugs Today"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.2165\/00023210-200418150-00004","article-title":"Remifentanil update: Clinical science and utility","volume":"18","author":"Beers","year":"2004","journal-title":"CNS Drugs"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"417","DOI":"10.2165\/00003495-199652030-00009","article-title":"Remifentanil","volume":"52","author":"Patel","year":"1996","journal-title":"Drugs"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1017\/S0265021508003761","article-title":"Comparison between dexmedetomidine and remifentanil for controlled hypotension during tympanoplasty","volume":"25","author":"Richa","year":"2008","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Fan, X., Cai, H., Pan, B., and Xie, Y. (2022). Comparison of dexmedetomidine and remifentanil on reducing coughing during emergence from anesthesia with tracheal intubation: A meta-analysis. Front. Pharmacol., 13.","DOI":"10.3389\/fphar.2022.993239"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1097\/ALN.0000000000003725","article-title":"Balanced Opioid-free Anesthesia with Dexmedetomidine versus Balanced Anesthesia with Remifentanil for Major or Intermediate Noncardiac Surgery","volume":"134","author":"Beloeil","year":"2021","journal-title":"Anesthesiology"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Zhang, Y., Jiang, W., and Luo, X. (2022). Remifentanil combined with dexmedetomidine on the analgesic effect of breast cancer patients undergoing modified radical mastectomy and the influence of perioperative T lymphocyte subsets. Front. Surg., 9.","DOI":"10.3389\/fsurg.2022.1016690"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1646","DOI":"10.1213\/ANE.0000000000001226","article-title":"The Effect of Dexmedetomidine on Postoperative Opioid Consumption and Pain After Major Spine Surgery","volume":"122","author":"Naik","year":"2016","journal-title":"Anesth. Analg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/11\/3711\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:40:18Z","timestamp":1760031618000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/11\/3711"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,26]]},"references-count":40,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["jcm14113711"],"URL":"https:\/\/doi.org\/10.3390\/jcm14113711","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,5,26]]}}}