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An epidural blood patch (EBP) is a surgical procedure that uses autologous blood, meaning the patient's own blood, in order to close one or many holes in the dura mater of the spinal cord, which occurred as a complication of a lumbar puncture or epidural placement. [1] [2] The punctured dura causes cerebrospinal fluid leak (CSF leak). [1]
Medical intervention Epidural administration A freshly inserted lumbar epidural catheter. The site has been prepared with tincture of iodine, and the dressing has not yet been applied. Depth markings may be seen along the shaft of the catheter. ICD-9-CM 03.90 MeSH D000767 OPS-301 code 8-910 [edit on Wikidata] Epidural administration (from Ancient Greek ἐπί, "upon" + dura mater) is a method ...
The epidural syringe is filled with autologous blood and injected in the epidural space in order to close holes in the dura mater. The treatment of choice for this condition is the surgical application of epidural blood patches, [27] [79] [80] which has a higher success rate than conservative treatments of bed rest and hydration. [81]
Combined spinal and epidural anaesthesia in labouring women is associated with more pruritus if fentanyl (25 μg) is given intrathecally, than low-dose epidural analgesia. However, no difference has been found in the incidence of post dural puncture headache , requirement for epidural blood patch or maternal hypotension.
It can be treated by more bedrest, or by an epidural blood patch, where the person's own blood is injected back into the site of leakage to cause a clot to form and seal off the leak. [17] The risk of headache and need for analgesia and blood patch is much reduced if "atraumatic" needles are used.
A small amount of the person's blood is injected into the epidural space near the site of the original puncture; the resulting blood clot then "patches" the meningeal leak. EBP is effective, [17] and further intervention is rarely necessary. 25–35% of patients suffer from transient back pain after EBP. [18]
Between them is the epidural space. The two layers of the dura mater separate at several places, with the meningeal layer projecting deeper into the brain parenchyma forming fibrous septa that compartmentalize the brain tissue. At these sites, the epidural space is wide enough to house the epidural venous sinuses. [2] [4] [5]
Epidural administration: injection into the epidural space of the spinal cord.Epidural, (Greek): situated on or outside the dura mater, from epi- "on top of" + dura mater + -al. Adhesion (Latin) adhēsiōn- for Latin adhaesiōn- (stem of adhaesiō) a clinging, equivalent to adhaes(us), past participle of adhaerēre to adhere + -iōn- -ion.