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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]
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]
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 ...
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.
Epidural steroid injections to treat sciatic pain have been linked as a cause of the disease by the U.S. Food and Drug Administration as well as in other research, and are therefore discouraged as a treatment for arachnoiditis as they will most likely worsen the condition. [29] [30] [31]
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.
Post-dural-puncture headache (PDPH) is a complication of puncture of the dura mater (one of the membranes around the brain and spinal cord). [3] The headache is severe and described as "searing and spreading like hot metal", involving the back and front of the head and spreading to the neck and shoulders, sometimes involving neck stiffness.
The prognosis is better if there was a lucid interval than if the person was comatose from the time of injury. Arterial epidural hematomas usually progress rapidly. However, venous epidural hematomas, caused by a dural sinus tear, are slower. [3] Outcomes are worse if there is more than 50 mL of blood in the hematoma before surgery.