[Autologous epidural blood patch and post-lumbar puncture headache. A review of a 1-year period at a central hospital]

Abstract

During a period of one year in which 609 spinal anaesthetics were performed, seven men and eight women complained of post lumbar puncture headache (PLPH). This form of headache was most frequently localized to the forehead and neck. The maximal intensities of the PLPH were assessed as "7-8" on a 10 cm visual analogous scale. All of these patients were treated with autologous epidural blood patch (AEBP). A mean volume of 17.8 ml autologous blood (range 10-20 ml) was injected into the epidural space. The injection was stopped as soon as low back pain occurred. The effect of AEBP occurred after a latent period with an average of two hours (range 0.5-6 hours). The effects of AEBP were indicated on a five-point ad hoc scale as "complete" or "nearly complete" in 13 out of 15 patients. Relapse occurred in one patient. No significant adverse effects were observed. AEBP is thus considered as a safe and effective form of treatment of PLPH.