RFA questions

[Baron S]

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1. I dilute 1cc of steroid in 10cc of 1% lidocaine and put 1cc at each site post burn.
2. 1cc of a 50/50 mix of 2% lidocaine/0.25% bupivicaine each site and wait 1 minute before burn.
3. I put 1cc of 0.25% bupivicaine in a TFESI if there's diagnostic utility. If it's a repeat injection, just saline. Also agree sometimes for an acute flare i will add some local.

 

[Ducttape]

1. no to steroid.
2. 1 cc of 2 % lidocaine.
3. only time I use local is with an inpatient. inpatients aren't going home and not at risk for falling due to leg weakness.

well, rarely with an "emergent" "new" disc herniation. last time was in early April.

 

[Ligament]

For the first 5 years or so of practice, I injected kenalog after RF lesions. Stopped doing it to spare my patients steroid exposure and noticed very little change in incidence or severity of RF neuritis, no change in RF efficacy either (ie no steroid effect from RF, or neither work at all I guess)

 

[manowar rules]

No steroid for RFN
1 ml 2% lido through each cannula and WAIT AT LEAST 90 SECONDS.
No local in TFESI - too many patients with weak legs and no benefit overall.

I completely agree that minute and a half waiting for the lidocaine to set up is the key. Impatient though we may be...