{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:56:59Z","timestamp":1777463819699,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2022,6,22]],"date-time":"2022-06-22T00:00:00Z","timestamp":1655856000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100002387","name":"National Cancer Institute, Cairo University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002387","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["British Journal of Pain"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite being a well-described intervention, the optimal anatomical approach to perform a stellate ganglion block (SGB) has been disputed. We compared the subfascial and extrafascial ultrasound-guided (USG) SGB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A randomised clinical trial was conducted, consisting of 50 patients in two groups. Group I received SGB via the subfascial approach while Group II received an SGB via the extrafascial approach. The primary endpoint was successful sympathetic blockade (as indicated by a measured temperature rise of \u22652\u00b0C). Secondary endpoints included analgesic efficiency (extent of early onset of pain relief as indicated by &gt;50% improvement in Visual Analogue Scale (VAS) score at 300\u2019s post-procedure); occurrence of Horner\u2019s syndrome; extent of local anaesthetic distribution; and adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean increase in sympathetic blockade was significantly higher in the subfascial group (2.6 \u00b1 0.6\u00b0C; p = .003). Analgesic efficacy was also significantly higher in the subfascial group ( p &lt; .001). The difference in the average dermatomal spread of local anaesthetic down to T2 and up to C4 between the groups was also statistically significant ( p = .021 and p = .019, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The degree of temperature rise, pain relief and occurrence of Horner's syndrome were higher in the subfascial than the extrafascial group. The subfascial approach to SGB, with a limited volume of local anaesthetic agent, is a more reliable technique when compared to the extrafascial approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20494637221109681","type":"journal-article","created":{"date-parts":[[2022,6,22]],"date-time":"2022-06-22T13:48:17Z","timestamp":1655905697000},"page":"610-618","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Subfascial versus extrafascial ultrasound-guided stellate ganglion block in patients with post-mastectomy sympathetically mediated pain: A randomized clinical trial"],"prefix":"10.1177","volume":"16","author":[{"given":"Mohamed Adly","family":"Elramely","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Pain Management, National Cancer Institute, Cairo University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0473-9764","authenticated-orcid":false,"given":"Ahmed","family":"Abdelaal Ahmed Mahmoud M Alkhatip","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Khaled","family":"Hamza","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Faculty of Medicine and Cairo University Hospital, Cairo University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Abdelhaq","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Faculty of Medicine and Cairo University Hospital, Cairo University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Elayashy","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Faculty of Medicine and Cairo University Hospital, Cairo University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ehab","family":"Farag","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed Shaker Ragab","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Management, National Cancer Institute, Cairo University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,6,22]]},"reference":[{"key":"bibr1-20494637221109681","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2018.06.002"},{"key":"bibr2-20494637221109681","doi-asserted-by":"publisher","DOI":"10.21037\/gs.2019.07.05"},{"key":"bibr3-20494637221109681","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000019834"},{"key":"bibr4-20494637221109681","doi-asserted-by":"publisher","DOI":"10.4103\/0366-6999.172589"},{"key":"bibr5-20494637221109681","volume-title":"Stellate ganglion blocks","volume":"2020","author":"Piraccini E","year":"2018"},{"key":"bibr6-20494637221109681","first-page":"365","volume-title":"Clin Imaging","volume":"27","author":"Wong W","year":"2002"},{"key":"bibr7-20494637221109681","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-014-0424-5"},{"key":"bibr8-20494637221109681","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-018-0660-1"},{"key":"bibr9-20494637221109681","doi-asserted-by":"publisher","DOI":"10.3390\/cancers11040443"},{"key":"bibr10-20494637221109681","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199508000-00026"},{"key":"bibr11-20494637221109681","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0232586"},{"key":"bibr12-20494637221109681","doi-asserted-by":"crossref","unstructured":"Abdi S, Zhou Y, Patel N, Saini B, Nelson J. A new and easy technique to block the stellate ganglion. Pain Physician. 2004 Jul;7(3):327\u2013331. 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Sympathetic Nerve Blocks for Pain Diagnosis and Therapy, Volume I: Fundamental Considerations and Clinical Applications. Publisher: Breon Laboratories (January 1, 1980). 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