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At my current setup, we only offer local anesthesia (no sedation) for procedures. RFA cannula sizing is 20g (lumbar) and 22g (cervical), MDT Accurian (no cooled RF setup). Needles are placed parallel to medial branch nerve with 90 seconds initial burn followed by a 180 degrees rotation for a 2nd burn. Patients do well with local and don't need sedation. Results are pretty good but I'm always wondering if I could optimize the outcome more by upsizing the needle gauge.
- For those who don't do sedations, can patients reasonably tolerate 18g lumbar & 20g cervical RFA with just local?
- My Cervical RFAs are done with 5mm active tip, would 10mm active tip be more optimal here?
- Genicular is pretty painful, so thinking of sticking with just 20g cannula?
- I'm adding steroid flush for upper cervical RFAs after burning due to possible neuritis. I know some people don't...thoughts on steroid flush after RFA?
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