Epidural Blood Patch for the Management of Post-dural Puncture Headache
Keywords:
Postdural puncture headache, epidural blood patchAbstract
Aim: Post-dural puncture headache (PDPH) is characterized by its severity and nausea in some patients after spinal and epidural anesthesia. The aim of this study is to evaluate the effect of epidural blood patch (EBP) application and compare it to the conservative treatment procedure in patients suffering from PDPH.
Material and Methods: Between 2004 and 2007, The American Society of Anesthesiologists (ASA) physical status I patients comprising 1446 spinal (1272 males and 174 females), 45 epidural (all males) and 2 combined spinal epidural (2 females) anesthesia were performed patients, were investigated retrospectively.
Results: PDPH was observed in a total of 14 patients (0.93 %). EBP was performed on 9 patients while the remaining 5 patients received conservative treatment. For EBP, 15 ml of autologous blood was injected into the epidural space. EBP provided complete relief from headache within 15-30 minutes in 9 patients.
Conclusion: Epidural blood patch is an effective procedure in severe PDPH. Oral paracetamol and caffeine combinations and intravenous hydration are also effective in symptomatic treatment.