Position and anatomical landmarks
The anatomical side of infiltration is dependent of the localisation of the scar. The scar is palpated to find the most painful spot(s) of the scar and recognised by the patient as a sharp pain.
The area around is disinfected covered with sterile drapes. A needle ((22G, 5 cm, 1 cm active tip) is inserted (under ultrasound guidance) the most painful spot(s) of the scar. The right spot is confirmed when the patient experiences a reproducible paresthesia in the scar by stimulation with 50 Hz, 0,5 V. Subsequently, a pulsed radiofrequency current of 45 V lasting for 120 seconds is administered without any preceding local anaesthetic. The maximum temperature should not exceed 42°C, but if this occurs the output should be reduced. If necessary, a second treatment period of 120 seconds can be administered if the impedance is above 500 Ω, prior to injection of 1 ml NaCl 0.9% solution.
2. Local haematoma