{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T10:38:08Z","timestamp":1783075088704,"version":"3.54.6"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T00:00:00Z","timestamp":1748649600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T00:00:00Z","timestamp":1748649600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100022026","name":"Aswan University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100022026","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Major lower limb orthopedic surgeries can lead to hemodynamic alterations and increase the risk of arteriovenous (AV)fistula thrombosis. This study assessed the role of stellate ganglion block (SGB) in preserving the AV fistulas in hemodialysis (HD)patients undergoing major lower limb orthopedic surgeries.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>In this randomized, controlled, double-blind trial, 50 chronic renal failure patients (ASA physical status III, aged 21\u201375 years) scheduled for major lower limb orthopedic surgeries were randomized into two groups: Group S received an ultrasound-guided SGB before spinal anesthesia, while Group C received a sham procedure. AVF function was assessed using Doppler ultrasonography on postoperative days 1 and 7. Primary outcome was AVF flow rate. Secondary outcomes included peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI), thrombosis rate, and functional failure.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Group S demonstrated significantly higher AVF flow rates on both postoperative day 1 (276.96\u2009\u00b1\u200949.66\u00a0ml\/min vs. 217.44\u2009\u00b1\u200946.73\u00a0ml\/min) and day 7 (254.96\u2009\u00b1\u200949.38\u00a0ml\/min vs. 204.56\u2009\u00b1\u200947.11\u00a0ml\/min), with large effect sizes (Cohen\u2019s d\u2009=\u20091.23 and 1.04, respectively; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). PSV and EDV were significantly improved, and RI was significantly lower in Group S. Thrombosis (8% vs. 36%) and failure rates (32% vs. 64%) were significantly reduced compared to the control group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Pre-emptive stellate ganglion block was associated with significantly improved AVF flow rate postoperatively and reduced thrombosis and functional failure, suggesting its clinical benefit in maintaining AVF patency during major surgeries in HD patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial registration<\/jats:title>\n            <jats:p>This study was approved by the Ethical Committee of Aswan University Hospitals, Egypt (Institutional Review Board (IRB 900\/2\/24)) and registered on clinicaltrials.gov (ID: NCT06300658). The registration time of this experiment is 3\/09\/2024. The study protocol was designed and implemented in accordance with the CONSORT guidelines. The study protocol was conducted in compliance with the relevant guidelines and standards.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12871-025-03150-7","type":"journal-article","created":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T05:06:55Z","timestamp":1748668015000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Stellate ganglion block for preserving arteriovenous fistula in hemodialysis patients undergoing major lower limb orthopedic surgeries: randomized control trial"],"prefix":"10.1186","volume":"25","author":[{"given":"Ayman Mohamady","family":"Eldemrdash","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soudy S.","family":"Hammad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek S.","family":"Hemaida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taha Tairy","family":"Dardeer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Adel","family":"Mohsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Khalaf","family":"Fathy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gamal Hendawy","family":"Shams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,31]]},"reference":[{"key":"3150_CR1","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1177\/1129729818809907","volume":"20","author":"M Rahimi","year":"2019","unstructured":"Rahimi M, Fakhar N, Sodagari P, Majedi H, Dashti H. The effect of stellate ganglion block on the function of arteriovenous fistulas for hemodialysis: A randomized trial. J Vasc Access. 2019;20:392\u20136.","journal-title":"J Vasc Access"},{"key":"3150_CR2","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1001\/jamasurg.2021.4527","volume":"156","author":"TS Huber","year":"2021","unstructured":"Huber TS, Berceli SA, Scali ST, Neal D, Anderson EM, Allon M, et al. Arteriovenous fistula maturation, functional patency, and intervention rates. JAMA Surg. 2021;156:1111\u20138.","journal-title":"JAMA Surg"},{"key":"3150_CR3","doi-asserted-by":"publisher","first-page":"615","DOI":"10.4103\/1319-2442.235183","volume":"29","author":"MK Zouaghi","year":"2018","unstructured":"Zouaghi MK, Lammouchi MA, Hassan M, Rais L, Krid M, Smaoui W, et al. Determinants of patency of arteriovenous fistula in Hemodialysis patients. 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The trial was registered prior to patient enrollment at clinicaltrials.gov (NCT06300658), Principal investigator: Ayman Mohamady Eldemrdash, Date of registration: 03\/09\/2024). The enrollment was from March 10, 2024, to July 29, 2024. Authors report that the content has not been published or submitted for publication elsewhere.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participant"}},{"value":"Declared consent for publication Not Applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"277"}}