Epidural Blood Patch

A number of our patients have asked for more information about epidural blood patch. Joseph Kim, MD, Chief of Anesthesia at Allegheny General Hospital, addresses these questions.

Why might a doctor recommend that a patient have an epidural blood patch?

An epidural blood patch is used for relief of severe headache that can result from spinal anesthesia, myelography, and diagnostic lumbar puncture. This headache is known as a postdural puncture headache (PDPH). PDPH has typical features of a postural headache that is worsened by standing and relieved by lying down. PDPH is initially treated conservatively with increased fluid and caffeine intake and analgesics. If the symptoms are severe, an epidural blood patch may be recommended. An epidural blood patch can be highly effective.

What is an epidural blood patch? Where is the blood for an epidural blood patch derived?

Epidural blood patch is performed by an anesthesiologist. A special needle is placed into the epidural space in the lower back using a sterile technique and equipment. About 15-25 ml of the patient's own blood is drawn and then immediately injected into the epidural space. The period that the blood is outside the patient is usually less than 30 seconds.

The procedure takes about 15 minutes to perform and is done in an outpatient setting. Recovery for the patient is about an hour. There is a chance that the epidural blood patch does not help the headache and in that situation the conservative treatment (fluid and caffeine intake) is continued.

Can a patient who is one of Jehovah’s Witnesses accept an epidural blood patch?

As epidural blood patch is a procedure using a patient’s own blood, it is a procedure about which patient who is a Jehovah’s Witness would need to make their own informed decision.

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