The op report reads:
Procedure: Left Radio-frequency ablation sacroiliac joint, specifically the dorsal ramus of L5 and lateral branches of S1, S2 and S3
After obtaining consent, the patient was placed in prone position. I identified the sacral ala and the superior articular process of S1. I prepped the area with chlorhexdine in the usual sterile fashion technique. I used lidocaine 2% for skin infiltration. I advanced the needle until I had good position of the junction between the sacral ala and the superior articular process of the left S1. Then we identified the most median and superior part of the left SI joint. I advanced the needle towards the most lower and inferior portion of the SI joint on the left side until I had good position of the needle into the above level in the AP and lateral views. The following technique was used to confirm placement at the median branch nerves.
Sensory stimulation was applied to each level at 50Hz; parenthesis were noted below 0.6 micro-volts. Motor stimulation was applied at 2Hz with 1 millisecond duration. corresponding paraspinal muscle twitching without extremity movement was noted. Following this, the needle trocar was removed and a syringe was removed and a syringe containing 0.25% bupivicaine was attached. At each level, after syringe aspiration with no blood return, 1 mL of 0.25% bupivicaine was injected to anesthetize the median branch nerve and surrounding tissue. After completion of each nerve block, a lesion was created at that level with a temperature of 80 degrees Celsius for 90 seconds. All injected medications were preservative free. Sterile technique was use throughout the procedure.
Any insight would be greatly welcome!!!!