Factors That Affect Radiofrequency Heat Lesion Size

Cosman, E.R.; Dolenský, J; Hoffman, Ryan

doi:10.1111/pme.12566

Cited by 193 publications

(138 citation statements)

References 45 publications

(139 reference statements)

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“…Motor testing was followed by the injection of 2% lidocaine 2 mL at each site. In the treatment group, each site was lesioned for 150 s with estimated tissue temperatures 77–80°C 20. In the sham group, simulated lesioning was performed at each level for 150 s, providing identical auditory and visual cues as the treatment group but without any RF current.…”

Section: Methodsmentioning

confidence: 99%

Radiofrequency ablation of genicular nerves prior to total knee replacement has no effect on postoperative pain outcomes: a prospective randomized sham-controlled trial with 6-month follow-up

Walega

McCormick

Manning

et al. 2019

Reg Anesth Pain Med

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Background and objectivesRefractory chronic knee pain from osteoarthritis (OA) is commonly treated with total knee arthroplasty (TKA). TKA can be associated with severe postoperative pain and persistent postsurgical knee pain. Poorly controlled postoperative pain can negatively effect functional outcomes following TKA, and effective opioid-sparing analgesia is key to the ideal recovery. Genicular nerve radiofrequency ablation (GN-RFA) has been shown in several trials to be clinically effective in patients with severe refractory knee pain from OA. We aimed to assess if preoperative GN-RFA would improve postoperative pain outcomes following TKA.MethodsThis was a sham-control prospective clinical trial in which blinded participants were randomized to image-guided GN-RFA or a simulated sham procedure 2-6 weeks prior to elective TKA. Outcomes were assessed at 48 hours and 1, 3 and 6 months following TKA.ResultsSeventy participants enrolled in this study. As compared with sham controls, GN-RFA had no treatment effect on postoperative opioid consumption, pain or functional measures at any time point.ConclusionsCooled RFA of the superior lateral, superior medial and inferomedial genicular nerves, when performed 2–6 weeks prior to elective TKA as part of a multimodal postoperative pain management regime, had no measurable effect on postoperative opioid use, analgesia use or function in the 48 hours following surgery. In addition, we found no longer term effect on outcome measures 1, 3 and 6 months after TKA.Trial registration number NCT02746874.

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Section: Methodsmentioning

confidence: 99%

Radiofrequency ablation of genicular nerves prior to total knee replacement has no effect on postoperative pain outcomes: a prospective randomized sham-controlled trial with 6-month follow-up

Walega

McCormick

Manning

et al. 2019

Reg Anesth Pain Med

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“…Factors affecting transmurality are primarily attributed to cathetertissue contact, applied energy, temperature, blood flow convection, and tissue composition (e.g. interposition of fat between catheter-tissue interface) [9][10][11]. Currently, conventional catheters do not provide information regarding the latter, in addition to confirming contact.…”

Section: Radiofrequency Ablation Of Atrial Fibrillationmentioning

confidence: 99%

Near-infrared spectroscopy integrated catheter for characterization of myocardial tissues: preliminary demonstrations to radiofrequency ablation therapy for atrial fibrillation

Singh‐Moon¹,

Marboe²,

Hendon³

2015

Biomed. Opt. Express

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Effects of radiofrequency ablation (RFA) treatment of atrial fibrillation can be limited by the ability to characterize the tissue in contact. Parameters obtained by conventional catheters, such as impedance and temperature can be insufficient in providing physiological information pertaining to effective treatment. In this report, we present a near-infrared spectroscopy (NIRS)-integrated catheter capable of extracting tissue optical properties. Validation experiments were first performed in tissue phantoms with known optical properties. We then apply the technique for characterization of myocardial tissues in swine and human hearts, ex vivo. Additionally, we demonstrate the recovery of critical parameters relevant to RFA therapy including contact verification, and lesion transmurality. These findings support the application of NIRS for improved guidance in RFA therapeutic interventions.

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“…при выпол-нении РчД Мпс существует необходимость точно-го позиционирования канюли для абляции рядом с целевым нервом, так как зона термоабляции не [21], это достигается исполь-зованием сенсорной и моторной стимуляции [22]. Для увеличения вероятности точного попадания в настоящее исследование не включались пациенты с избыточным весом, деформацией позвоночни-ка, выраженными дегенеративными изменени-ями суставов.…”

Section: результаты и обсуждениеunclassified

Potential of Ultrasound-Guided Lumbar Facet Radiofrequency Denervation

Волков

Карабаев

Пташников

et al. 2017

Traumatology and Orthopedics of Russia

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The aim of the study was to evaluate the possibility of US navigation for Radiofrequency denervation (RFD) of the lumbar facets.Material and methods. The authors performed a prospective controlled cohort study which included 50 patients with chronic pain syndrome who underwent RFD LIII-SI facets on both sides. The main group (US) included 25 patients, who underwent US guided navigation with FScontrol of the correct placement of the cannula prior to ablation. In the control group (FS) the RFD was performed only under FS control. Patients were selected after preliminary test block of medial branch with 50% pain reduction from the baseline. Patients with overweight, spinal deformity, pronounced degenerative changes, spinal stenosis and developmental anomalies were not included in the study. For the evaluation of outcomes, the numeric pain scale NRS-11 and the Oswestry index (ODI) were used, the accuracy of the cannula position was assessed and factors determining the accuracy were searched.Results. As a result of the intervention, there was a significant decrease of NRS-11 and ODI criteria in both groups (p0.001), a positive outcome was achieved in 18 (72%) of US patients and 16 (64%) of FS patients, p = 0.564. Of the 200 attempts to position the cannula under the ultrasound control, 169 (84.5%) were successful, in most cases (187 out of 200, 93.5%) at least 3 attempts were required to reposition the cannula. The average time for performing the procedure under the ultrasound control was 47.3±1.13 minutes. The facet angle and procedure level were defined as predictors of the cannula positioning accuracy, odds ratio 0.93 (95% CI 0.894–0.963) and 0.51 (95% CI 0.32–0.805), respectively.Conclusion. RFD of lumbar facet under ultrasound navigation allows to achieve a relatively high accuracy of the cannula position into the zone of passage of the articular branch. The navigation capabilities are reduced at the level of LV and SI vertebrae due to structural features of the joints, namely coronary orientation of the facets with the formation of a narrow space between the transverse and upper articular process, which create difficulties for scanning. The disadvantage of ultrasound control is the lengthy procedure and the need for repeated reinsertion of the cannulae worsening the patient’s tolerance of procedure.

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Factors That Affect Radiofrequency Heat Lesion Size

Abstract: Tip gauge, tip length, temperature, and time substantially affect RF lesion size.

Cited by 193 publications

References 45 publications

Radiofrequency ablation of genicular nerves prior to total knee replacement has no effect on postoperative pain outcomes: a prospective randomized sham-controlled trial with 6-month follow-up

Radiofrequency ablation of genicular nerves prior to total knee replacement has no effect on postoperative pain outcomes: a prospective randomized sham-controlled trial with 6-month follow-up

Near-infrared spectroscopy integrated catheter for characterization of myocardial tissues: preliminary demonstrations to radiofrequency ablation therapy for atrial fibrillation

Potential of Ultrasound-Guided Lumbar Facet Radiofrequency Denervation

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