The Effect of Fluid Injection on Lesion Size During Radiofrequency Treatment

Provenzano, David; Lassila, Holly C.; Somers, David L.

doi:10.1097/aap.0b013e3181e82d44

Cited by 54 publications

(59 citation statements)

References 21 publications

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“…However, there is some evidence that fluid injection (alongside its composition), similar to our postulation regarding local anaesthetic infiltration, can affect lesion size and outcomes. However, our series contrasts with this published literature [10][11][12][13]16]. This could in part be due to differing settings and radiofrequency device set ups.…”

Section: Discussioncontrasting

confidence: 80%

“…This is the first study in man regarding the basic processes of impedance-controlled bipolar radiofrequency lesion sizes. Other studies have focussed on in vitro and animal models in the context of pain medicine or cardiology [10][11][12][13][14][15][16][17][18][19]. This evidence base cannot be readily compared as some focus on temperature-modulated devices whilst others on impedance-controlled radiofrequency.…”

Section: Discussionmentioning

confidence: 99%

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Radiofrequency ablation in snoring surgery: local tissue effects and safety measures

Virk

Kumar

Al-Okati

et al. 2014

Eur Arch Otorhinolaryngol

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Radiofrequency ablation is now widely used in the treatment of patients with snoring and obstructive sleep apnoea. It is well suited to the multilevel approach typically required in snoring surgery and can be used interstitially or in cutting mode. However, no research has been performed to analyse the collateral local tissue damage or size of lesions induced by radiofrequency application. This is the first study of the histological effects of interstitial radiofrequency. We studied the size of tissue lesions generated at differing power settings with and without local anaesthetic application in human tonsils and chicken breast tissue. The size of the lesion was independent of power setting and local anaesthetic infiltration. The typical effect was an oval-shaped lesion centred on the active electrode, 6-7 mm in width and 7-8 mm in length. This was confirmed histopathologically, with smaller lesions generated in the submucosa (2 × 3 mm) but with no collateral tissue damage beyond this distinct zone of injury. To avoid complications, we recommend placing contiguous radiofrequency applications at least 8 mm apart. Post-nasal space packing raises and tautens the soft palate. The use of local anaesthetic increases interstitial volume, thereby reducing the risk of incorrect probe placement and resultant ulceration or fistulation.

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Section: Discussioncontrasting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Radiofrequency ablation in snoring surgery: local tissue effects and safety measures

Virk

Kumar

Al-Okati

et al. 2014

Eur Arch Otorhinolaryngol

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“…Because of the small lesion size, multiple lesions need to be created around each foramen to interrupt all or most of the nociceptive input transmitted from the SIJ. Another technique often used to amplify lesion size is fluid modulation (i.e., injecting fluid before lesioning), which likely acts via alterations in thermal and electrical conductivity properties [106,107]. …”

Section: Conventional Rfmentioning

confidence: 99%

Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment

Cohen

Chen

Neufeld

2013

Expert Review of Neurotherapeutics

336

236

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Sacroiliac joint (SIJ) pain is an underappreciated source of mechanical low back pain, affecting between 15 and 30% of individuals with chronic, nonradicular pain. Predisposing factors for SIJ pain include true and apparent leg length discrepancy, older age, inflammatory arthritis, previous spine surgery, pregnancy and trauma. Compared with facet-mediated and discogenic low back pain, individuals with SIJ pain are more likely to report a specific inciting event, and experience unilateral pain below L5. Owing in part to its size and heterogeneity, the pain referral patterns of the SIJ are extremely variable. Although no single physical examination or historical feature can reliably identify a painful SIJ, studies suggest that a battery of three or more provocation tests can predict response to diagnostic blocks. Evidence supports both intra- and extra-articular causes for SIJ pain, with clinical studies demonstrating intermediate-term benefit for both intra- and extra-articular steroid injections. In those who fail to experience sustained relief from SIJ injections, radiofrequency denervation may provide significant relief lasting up to 1 year. This review covers all aspects of SIJ pain, with the treatment section being primarily focused on procedural interventions.

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“…Before activating the RF generator (Neuro N50, Stryker Leibinger GmbH & Co. KG, Freiburg, Germany), 1% lidocaine (0.5 mL) was injected to enhance lesion size, 14 and impedance was confirmed. The lesions were made by …”

Section: Randomization and Interventionmentioning

confidence: 99%

An Alternative Distal Approach for the Lumbar Medial Branch Radiofrequency Denervation

Moon

Lee

Kim

et al. 2013

Anesthesia &Amp; Analgesia

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The Effect of Fluid Injection on Lesion Size During Radiofrequency Treatment

Cited by 54 publications

References 21 publications

Radiofrequency ablation in snoring surgery: local tissue effects and safety measures

Radiofrequency ablation in snoring surgery: local tissue effects and safety measures

Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment

An Alternative Distal Approach for the Lumbar Medial Branch Radiofrequency Denervation

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