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Radio Frequency in Pain
Radio Frequency in Pain
jameer. kamate
Fellow
in pain and nerve block
Axon pain
management centre, hyderabad
Modalities
Continuous radiofrequency
Pulsed radiofrequency
Mechanism of action
Radiofrequency current (low energy, high
frequency)
Heat production
Continuous radiofrequency:
Continuous current
Alternating current
Temperature< 42degrees
Patient selection
Consent
Procedure
Local anesthesia is infiltrated in target site, Using X-ray; guide the needle to
the exact target area. A microelectrode is then inserted through the needle
to begin the stimulation process.
Once the needle and electrode placement are verified, a small
radiofrequency current is sent through the electrode into the surrounding
tissue, causing the tissue to heat.
Postoperative notes
-Not to drive or operate machinery -24 hours after the procedure.
-Resume normal diet.
-Not to engage in any strenuous activity -24 hours after the procedure.
-Not to take a bath for 1 to 2 days after the procedure.
Specific indications
Trigeminal neuralgia: The needle electrode is passed under fluoroscopic
guidance through foramen ovale to trigeminal ganglion that lies close to
cranial opening of foramen ovale.
Cervical cordotomy: Creation of lesion in lateral spinothalamic tract on
contra lateral side of pain. This reduces pain sensation but retains
temperature and proprioception which are carried by dorsal columns.
Cervicogenic headache: ablation of third and greater occipital nerve.
Spinal pain: median branch neurotomy supplying the facet joints.
Groin pain and orchalgia: radiofrequency ablation of genitofemoral, ilio-
inguinal nerves and nerve roots.
Miscellaneous syndromes: deafferentation, plexus avulsion, post-surgical
neuropathic pain, spinal radicular pain, post surgical thoracic pain.
Complications
-Pain or discomfort around the injection site
-Numbness of skin covering the injection site
-Worsened facet or sacroiliac joint pain due to muscle spasm in the area of
the injection
-Permanent nerve pain
-Allergies or reactions to medications used
-Infection