​RF PROCEDURE PROTOCOL

RF PROCEDURE PROTOCOL

Basic Set-Up Requirements:
   1. RF generator
   2. Power cable
   3. Electrode connecting cable (sterile)
   4. Electrode (sterile)
   5. Patient plate (ground pad) cable
   6. Patient plate (disposable)
   7. Cannulae (disposable)

Helpful Hints
   1. Check sterilization capabilities for facility.
   2. Ascertain physician's electrode and cannula preferences.
   3. Have more than one electrode, connecting cable and plenty of cannulae.
   4. Inquire the time and temp settings prior to procedure and save them
   5. Train staff before procedure

Procedure Protocol:
   1. Patient (PT) in prone position under conscious sedation.
   2. Done under fluoroscopy.
   3. Patient plate connected to patient's thing (lumbar/lower thoracic procedure) or upper arm (cervical/upper thoracic procedure).
   4. Physician selects appropriate cannula in the location of patient's pain.
   5. Physician places cannula in location of patient's pain.
   6. After cannula is placed, the stylet is removed and the electrode is inserted.
   7. To confirm cannula is a long painful nerve, stimulation must be performed.
   8. Impedance (resistance to flow of current) will fluctuate and should consistently read between 300 and 700 ohms.
   9. Sensory stimulation should be performed first at 50 Hz increasing voltage to 1 volt at which point the patient should have a positive pain response.
   10. If positive at 1 volt, motor stimulation is performed. If patient is not responsive at 1 volt, cannula is repositioned and sensory stimulation is repeated.
   11. Motor stimulation is performed at 2 Hz increasing voltage to 3 volts where the patient should have a negative motor response (no radicular twitching should occur, although axial reaction is acceptable).
   12. If patient does not respond positively (twitching) to motor stimulation, the cannula is repositioned and the physician must perform sensory stimulation again before proceeding back to motor stimulation.
   13. After stimulating in both Sensory and Motor nodes, lesioning (burning) is performed by regular or radiofrequency settings.
   14. The physician will select the appropriate temperature (70ͦº C - 90º C) for a length of time (60 seconds to 120 seconds) and then begin lesioning.