{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:09:35Z","timestamp":1785420575355,"version":"3.56.0"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":210,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Research and Management"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Fibromyalgia is a chronic pain syndrome characterized by widespread pain, fatigue, and sleep disturbance. Many patients remain symptomatic despite guideline\u2010concordant pharmacologic therapy. Stellate ganglion block (SGB) modulates sympathetic activity and may provide an adjunctive option for fibromyalgia\u2010related pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this single\u2010center, randomized, single\u2010blind, sham\u2010controlled trial, adults fulfilling the 2016 American College of Rheumatology criteria and receiving stable duloxetine 60\u2009mg\/day were randomized 1:1 to ultrasound\u2010guided SGB or a sham procedure. Two procedures were performed 1\u2009week apart. The primary endpoint was change in the Fibromyalgia Impact Questionnaire Revised (FIQR) total score from baseline to 1\u2009week. Secondary endpoints included FIQR change at 1\u2009month, pain intensity on an 11\u2010point Numerical Rating Scale (NRS), and FIQR responder rates (\u2265\u200930% and \u2265\u200950% improvement). Primary analyses were per\u2010protocol (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200960), with modified intention\u2010to\u2010treat (mITT,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200960) and last observation carried forward (LOCF,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200968) sensitivity analyses. ANCOVA was adjusted for baseline FIQR.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 108 screened patients, 68 were randomized (SGB\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200933; control\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200935); 60 (30 per group) completed all assessments. Baseline FIQR was 87.7\u2009\u00b1\u20097.1 in the SGB group and 82.0\u2009\u00b1\u200911.3 in controls. At 1\u2009week, FIQR decreased to 53.4\u2009\u00b1\u200919.0 with SGB versus 77.2\u2009\u00b1\u200916.3 with control; at 1\u2009month, FIQR was 63.1\u2009\u00b1\u200920.3 versus 80.2\u2009\u00b1\u200910.7, respectively. ANCOVA\u2010adjusted between\u2010group differences in FIQR change favored SGB by \u221229.9 points (95% CI \u221237.9 to \u221221.9;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) at 1\u2009week and \u221222.9 points (95% CI \u221230.1 to \u221215.7;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) at 1\u2009month. NRS pain reductions were also significantly greater with SGB at both time points (adjusted difference \u22123.1 points, 95% CI \u22124.1 to \u22122.0,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001 at 1\u2009week; \u22122.6 points, 95% CI \u22123.6 to \u22121.6,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001 at 1\u2009month). No serious complications occurred; adverse events were transient and mild.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In treatment\u2010resistant fibromyalgia patients receiving stable duloxetine, ultrasound\u2010guided SGB produced clinically meaningful short\u2010term improvements in fibromyalgia impact and pain with an acceptable safety profile. However, the large effect sizes should be interpreted cautiously given potential unblinding and placebo effects. Larger, multicenter trials with longer follow\u2010up, objective outcome measures, and formal blinding assessment are warranted.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      ClinicalTrials.gov Identifier: NCT07343128\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/prm\/4146674","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:32:14Z","timestamp":1785418334000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound\u2010Guided Stellate Ganglion Block in Fibromyalgia: A Randomized, Single\u2010Center, Single\u2010Blind, Sham\u2010Controlled Trial"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0899-4631","authenticated-orcid":false,"given":"Yagmur Can","family":"Dadakci","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"e_1_2_15_1_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-020-00506-w"},{"key":"e_1_2_15_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.3266"},{"key":"e_1_2_15_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209724"},{"key":"e_1_2_15_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-996-0012-4"},{"key":"e_1_2_15_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keab146"},{"key":"e_1_2_15_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2020.110000"},{"key":"e_1_2_15_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/24705470211055176"},{"key":"e_1_2_15_8_2","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/0304-3959(88)90086-3","article-title":"Regional Sympathetic Blockade in Primary Fibromyalgia","volume":"33","author":"Bengtsson A.","year":"1988","journal-title":"Pain"},{"key":"e_1_2_15_9_2","doi-asserted-by":"publisher","DOI":"10.1589\/jpts.27.209"},{"key":"e_1_2_15_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/ar2783"},{"key":"e_1_2_15_11_2","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.081090"},{"key":"e_1_2_15_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7321.1123"},{"key":"e_1_2_15_13_2","first-page":"E251","article-title":"Contribution of Clinical Trial Design to Bias in Interventional Pain Management: Analysis of Randomized Trials of Epidural Injections","volume":"14","author":"Manchikanti L.","year":"2011","journal-title":"Pain Physician"},{"key":"e_1_2_15_14_2","doi-asserted-by":"publisher","DOI":"10.4103\/2229-3485.83221"},{"key":"e_1_2_15_15_2","first-page":"1339","article-title":"Intention-To-Treat Principle","volume":"165","author":"Montori V. 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