www.elsevier.com/locate/trap Available online at www.sciencedirect.com Radiofrequency techniques: Complications and troubleshooting Gisela Roca, MD, PhD a,n , Javier de Andrés Ares, MD, FIPP b , Maria Luisa Franco Gay, MD c , Consuelo Nieto, MD, PhD d , Maria Teresa Bovaira, MD, FIPP e a Department of Anesthesiology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain b Department of Anesthesiology, Hospital Universitario La Paz, Madrid, Spain c Clinica Vizcaya, Bilbao, Spain d Department of Anesthesiology, Hospital Universitario Fundacion Alcorcon, Madrid, Spain e Department of Anesthesiology, Hospital Intermutual de Levante, Valencia, Spain article info Keywords: Radiofrequency ablation Chronic pain Complication abstract Radiofrequency (RF) is a minimally invasive, target-selective technique that has demon- strated success in reducing pain in several chronic pain conditions. The lack of standard continuous RF ablation protocols for specific targets makes it difficult to compare the percentage of complications of RF between different studies addressing the same pain syndrome. The present article reviews the most frequent complications associated with the most widely used percutaneous continuous RF techniques in pain treatment, and the strategies used to minimize such complications. & 2015 Elsevier Inc. All rights reserved. Introduction Radiofrequency (RF) is a minimally invasive, target-selective technique that has demonstrated success in reducing pain in several chronic pain conditions. However, the growing use of RF is still not based on good-quality evidence. Regarding this, the difficulty in conducting methodologically sound studies is because of problems in assessing chronic pain (a subjective variable) and in obtaining a homogeneous study population, as in many chronic pain syndromes, it is not easy to establish a precise etiological diagnosis. Conversely, evaluation of the balance between the analgesic efficacy and complications of an interventional technique adds both difficulties in design- ing the comparator arm and bias generated by the experience of the individual performing the technique. 1 Furthermore, the lack of standard continuous RF ablation protocols for specific targets makes it difficult to compare the percentage complications of RF between different studies addressing the same pain syndrome. The present article reviews the most frequent complica- tions associated with the most widely used percutaneous continuous RF techniques in pain treatment and the strat- egies used to minimize such complications. Complications related to the circuit Monopolar RF systems use grounding pads to complete the RF circuit. Thermal injuries at the grounding pad site have been increasingly reported with the use of higher currents http://dx.doi.org/10.1053/j.trap.2015.01.005 1084-208X/& 2015 Elsevier Inc. All rights reserved. n Corresponding author. E-mail address: giselaroca@gmail.com (G. Roca). T ECHNIQUES IN R EGIONAL A NESTHESIA AND P AIN M ANAGEMENT 18(2014) 25 – 34