Factors That Affect Radiofrequency Heat Lesion Size. Issue 12 (14th October 2014)

• Record Type: Journal Article
• Authors: Cosman, Eric R.; Dolensky, Joseph R.; Hoffman, Ryan A.
• Is Part Of: Pain medicine. Volume 15:Issue 12(2014)
• Page Start: 2020
• Page End: 2036
• Publication Date: 2014-10-14
• Subjects: Pain -- Periodicals; Pain -- Treatment -- Periodicals; Analgesics -- Periodicals; Pain -- Periodicals; Pain Management -- Periodicals; Douleur -- Périodiques; Douleur -- Traitement -- Périodiques; Analgésiques -- Périodiques; Analgésique; Soulagement de la douleur; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.047205
• DOI: 10.1111/pme.12566
• Languages: English
• ISSNs: 1526-2375

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="pme12566-sec-0001" sec-type="section"> <title>Objective</title> <p>This study aims to compare radiofrequency (RF) heat lesion size across electrodes and generator settings available for interventional pain management.</p> </sec> <sec id="pme12566-sec-0002" sec-type="section"> <title>Methods</title> <p>Monopolar lesions are generated ex vivo in animal tissue using sharp cannulae with tip diameters 23, 22, 20, 18, 16 gauge; tip lengths 5, 6, 10, 15 mm; set temperatures 60, 70, 80, 90°C; set times 1, 1.5, 2, 3, 5, 10 minutes. Lesions are generated using the RRE electrode, cooled RF, and parallel‐tip bipolar RF for comparison. Lesion sizes are assessed by automated photographic temperature inference from over 400 lesions, using multiple lesions per configuration.</p> </sec> <sec id="pme12566-sec-0003" sec-type="section"> <title>Results</title> <p>Monopolar lesion width and length increase with each factor (<italic>P</italic> < 0.001). Increasing cannula diameter from 22 to 16 gauge increases average lesion width 58–65% (3–4 mm) at 80°C and 2 minutes. Increasing temperature from 60°C to 90°C increases lesion width 108–152% at 2 minutes. Although dimensions grow most rapidly over the first minute, average lesion width is 11–20% larger at 2 minutes, and 23–32% larger at 3 minutes, compared with 1 minute. Lesion length extends distal and proximal to the tip, and exceeds tip length by 1–5 mm at 80°C and 2 minutes. Conventional 16 gauge cannulae at 80–90°C for 2–3 minutes generate lesions of average width similar to that produced by the cooled RF configuration proposed for sacroiliac joint denervation. Bipolar RF between parallel cannulae produces a rounded brick‐shaped lesion of comparable shape to three sequential monopolar lesions generated using the same cannulae and generator settings.</p> </sec> <sec id="pme12566-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Tip gauge, tip length, temperature, and time substantially affect RF lesion size.</p> </sec> </abstract>