Radio frequency
Definition
It involves the passage of a high frequency current through a cannula that is totally isolated except for the tip (2-4 mm) which is the active part and the one that will exert the therapeutic action. As the current passes through the cannula, the temperature in it rises at the tip and in the rest it is totally isolated. The degree of temperature reached is controlled voluntarily.
Mechanism of action
The increase in temperature in a target, generally a sensitive nerve responsible for the pain, has as a consequence the interruption in the transmission of pain (in the case of thermal radiofrequency at 80º) or as a modification in the transmission (in the pulsed radiofrequency at 40º). The procedure is performed under local anesthesia and sedation.
Secondary effects
The technique in expert hands and following safety advice, has few side effects. The procedure must be performed in an operating room to maintain asepsis, and with the assurance of an exact view of the area where the cannula is inserted (that is, under radiological control). It is not about any medication and as it is a physical technique, there are the effects derived from the discomfort of the infiltration that are minimal due to local anesthesia and sedation. Others, in the case of not controlling the insertion of the cannula, could lead to an unwanted puncture in another structure and / or a vessel between them and cause a hematoma.
Other safety measures regarding the technique would be the verification of the sensory and motor stimulation once we have the cannula in the appropriate location and controlled radiologically. With the appropriate questions to the patient and before proceeding to practice radiofrequency, stimulation is practiced with parameters in which the patient perceives a tingling (paresthesia) in the area that usually has pain. This represents that we have the cannula in the correct position. To corroborate that it is not a motor nerve, it is asked and visualized, by giving a more powerful stimulation than any structure (arm, leg) moves when applying this shock. If so, the cannula must be repositioned.
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