The epidural blood patch--current practices and concerns

Abstract

Post dural puncture headache is a common sequelae of spinal and, sometimes, epidural anesthesia. Since 1960, the practice of placing autologous blood into the epidural space to treat spinal headache has been used with great success. The blood patch can provide immediate symptom relief from spinal headache and repair of the CSF leak, which is the basic mechanism of post dural puncture headache. Discrepancies exist in the literature and in today's common practice regarding technique and timing for this treatment. This is a procedure not without complications and requires caution. Contained herein are recommendations for safe and effective use of the epidural blood patch. Following these procedures, anesthetists will likely see an 85% to 98% immediate cure rate for post dural puncture headache with the fewest possible complications.