{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T14:56:42Z","timestamp":1792594602558,"version":"4.5.0"},"reference-count":28,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Awake procedures performed under spinal anesthesia (SA) have been associated with reduced hospitalization, costs, and postoperative complications compared with general anesthesia (GA). Endocan, an endothelial cell-specific proteoglycan, serves as a biomarker of endothelial activation and vascular dysfunction and may reflect the differential vascular and immunomodulatory effects of anesthetic techniques. This prospective observational study aimed to compare perioperative changes in circulating endocan levels between patients undergoing surgery under GA and SA. Methods: Eighty adult patients (aged 18\u201365 years, ASA I\u2013II) scheduled for elective surgery were included and assigned to GA (n = 42) or SA (n = 38) based on standard clinical indications. Serum endocan levels were measured preoperatively, at 6 h, and at 24 h postoperatively using an ELISA assay. Results: In the GA group, endocan levels increased significantly from baseline (304.5 \u00b1 80.7 pg\/mL) to 6 h (511.5 \u00b1 88.7 pg\/mL, p &lt; 0.001), and although partially decreased by 24 h (427.5 \u00b1 87.9 pg\/mL, p &lt; 0.001), remained above baseline. In the SA group, endocan rose from baseline (320.7 \u00b1 72.5 pg\/mL) to 6 h (415.2 \u00b1 79.5 pg\/mL, p &lt; 0.001) but returned near baseline at 24 h (352.6 \u00b1 84.7 pg\/mL, p = 0.233). Conclusions: These findings suggest that while surgery induces endothelial activation in both groups, GA is associated with a more sustained endothelial response than SA.<\/jats:p>","DOI":"10.3390\/jcm14228076","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T16:46:22Z","timestamp":1763138782000},"page":"8076","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["General Anesthesia or Spinal Anesthesia and Serum Endocan Release After Surgery: A Prospective Observational Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5344-8250","authenticated-orcid":false,"given":"Ergun","family":"Gunduz","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Faculty of Medicine, Istanbul Atlas University, 34408 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9272-9098","authenticated-orcid":false,"given":"Sinem","family":"Durmus","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Faculty of Medicine, Izmir Katip Celebi University, 35620 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4735-4091","authenticated-orcid":false,"given":"Naile Fevziye","family":"Misirlioglu","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Faculty of Medicine, Istanbul Atlas University, 34408 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oguzhan","family":"Cucu","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Medicana Zincirlikuyu Hospital, 34394 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8893-2926","authenticated-orcid":false,"given":"Seyma","family":"Dumur","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Faculty of Medicine, Istanbul Atlas University, 34408 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1052-5911","authenticated-orcid":false,"given":"Bagnu","family":"Dundar","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Faculty of Medicine, Istanbul Atlas University, 34408 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1347-8498","authenticated-orcid":false,"given":"Hafize","family":"Uzun","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Faculty of Medicine, Istanbul Atlas University, 34408 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"E2","DOI":"10.3171\/2021.9.FOCUS21433","article-title":"Awake spinal surgery: Simplifying the learning curve with a patient selection algorithm","volume":"51","author":"Letchuman","year":"2021","journal-title":"Neurosurg. 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