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Epidural Blood Patch by Deanna M. Neff, MPH

Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor

Definition

An epidural blood patch is when a small amount of blood is used to seal a puncture site in the spine as a result of a spinal tap procedure . The patch helps restore normal pressure in the spinal fluid.

Spinal Tap

Reasons for Procedure

This procedure is done to relieve a spinal headache that does not go away on its own. A spinal headache can develop after a spinal tap procedure when too much spinal fluid leaks internally and reduces pressure in the spine.

This procedure is quite common and relief is often immediate.

Possible Complications

Complications are rare, but no procedure is completely free of risk. If you are planning to have an epidural blood patch, your doctor will review a list of possible complications, which may include:

Bleeding
Bad reaction to the anesthesia, contrast dye solution, or sedative medicine (eg, light-headedness, low blood pressure, and/or wheezing)
Infection

Factors that may increase the risk of complications include:

Taking blood thinners prior to the procedure
Current infection

Be sure to discuss these risks with your doctor before the epidural blood patch.

What to Expect

Prior to Procedure

Your doctor will do a thorough physical exam and explain the risks and benefits of the procedure.
Discuss all allergies with your doctor.
You will need to sign a consent form.
Arrange for a ride home.
You may be asked to stop eating and drinking for 2-6 hours before the procedure.
If possible, you will be asked to stop taking aspirin , anti-inflammatory medicines, certain supplements (eg, vitamin E ), and blood-thinning medicines for up to 10 days before the procedure. Discuss stopping these medicines with your doctor.
You may be asked to avoid certain herbal supplements prior to the procedure, such as fish oil .
Take your other medicines as usual.

Anesthesia

Local anesthesia will be used at the puncture site, so you should not feel any pain during the procedure.

Description of the Procedure

In the operating room, two IVs (needles) will be inserted in your arms for medicines and fluids and drawing blood. You may be given a sedative to ease anxiety.

You will lie face down on the table. The doctor will wash and sanitize your back. An x-ray machine may be used to help the doctor guide a small needle to the area where spinal fluid is leaking. Contrast dye solution will be injected and more x-rays will be taken. The doctor will draw a small amount of your blood and inject it into the correct area of the spine. This should clot, or seal, the leakage.

How Long Will It Take?

About 30 minutes

How Much Will It Hurt?

You will remain awake and be asked to lie still during the procedure. Local anesthesia injected should block any pain. You may feel a slight pressure during the procedure.

Average Hospital Stay

After resting, you may be able to go home the same day.

Post-procedure Care

At the Hospital

You will be taken to a recovery room for a few hours.
You will be asked to lie flat and still.
You will be monitored and given IV fluids.
After a few hours, you will be asked to get up and move around slowly.

At Home

When you return home, do the following to help ensure a smooth recovery:

Continue bed rest and gradual gentle movement for the first 24 hours.
For 2-3 days, avoid sudden movements, lifting, or strenuous physical activity.
Drink plenty of fluids. You may eat a normal diet.
Return to your activities as tolerated.
Be sure to follow your doctor’s instructions .

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:

Continued pain or discomfort (beyond 24 hours)
Signs of infection, including fever and chills
Limb weakness, numbness, or unusual sensations
Trouble emptying bladder or bowels
Stiff neck

In case of an emergency, call for medical help right away.

RESOURCES:

The American Congress of Obstetricians and Gynecologists http://www.acog.org/
American Family Physician http://www.aafp.org/
International Anesthesia Research Society http://www.anesthesia-analgesia.org/

CANADIAN RESOURCES:

Canadian Anesthesiologists’ Society http://www.cas.ca/
The Society of Obstetricians and Gynecologists Canada http://www.sogc.org/index_e.asp

References:

Krovvidi H, Hasan M. Epidural blood patch. CPD Anaesthesia . 2003;5(2):94-97.
Newton Wellesley Hospital. Epidural blood patch. Newton Wellesley Hospital website. Available at: http://www.nwh.org/clinical-centers/pain-management-service/services-provided/epidural-blood-patch/ . Accessed June 17, 2010.
University of Wisconsin School of Medicine and Public Health. Epidural blood patch. University of Wisconsin School of Medicine and Public Health website. Available at: http://www.uwhealth.org/healthfacts/B_EXTRANET_HEALTH_INFORMATION-FlexMember-Show_Public_HFFY_1105110029981.html . Accessed June 17, 2010.

Last reviewed June 2012 by Michael A. Cosgrove, MD

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