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by Scholten A

Epidural Blood Patch

Definition

An epidural blood patch is a procedure to stop spinal fluid from leaking. It uses a small amount of blood to seal the leak. It is done after a lumbar puncture (LP).
Lumbar Puncture
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Reasons for Procedure

This procedure is done to ease a spinal headache that does not go away on its own. A spinal headache can happen after an LP. Too much spinal fluid leaks and lowers pressure in the skull.

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over problems that could happen, such as:
  • Problems from the anesthesia, sedative, or contrast material
  • Bleeding
  • Infection
Things that may raise the risk of problems are:
  • Smoking
  • Long term health problems such as diabetes or obesity
  • Having an infection

What to Expect

Prior to Procedure

The doctor may meet with you to talk about:
  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before the procedure
  • Fasting before the procedure, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from the procedure

Anesthesia

The doctor will give local anesthesia—the area will be numbed. Medicine may help you relax.

Description of the Procedure

An x-ray may help guide a small needle to the area where spinal fluid is leaking. Contrast material will be injected. It will help the doctor see the area better. More x-rays will be taken. A small amount of blood will be drawn. The blood will then be injected into the correct area of the spine. This should clot, or seal, the leakage.

How Long Will It Take?

About 30 minutes

Will It Hurt?

There may be slight pressure during the procedure.

Average Hospital Stay

You may be able to go home the same day. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Hospital
Once the LP is done, you will be asked to lie flat and still. After a short time, you will be asked to get up and move around.
At Home
Some activities may be limited for a few days. You will need to delay your return to work during this time.

Call Your Doctor

Call your doctor if you are not getting better or you have:
  • Pain that lasts longer than 24 hours
  • Fever or chills
  • Weakness, numbness, or an unusual feeling in your legs or arms
  • Problems passing urine (pee) or stool (poop)
  • Stiff neck
If you think you have an emergency, call for medical help right away.

RESOURCES

American College of Obstetricians and Gynecologists
https://www.acog.org
Family Doctor—American Family Physician
https://familydoctor.org

CANADIAN RESOURCES

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

References

Anesthesia epidural blood patch. UW Health website. Available at: https://patient.uwhealth.org/healthfacts/6098. Accessed September 28, 2021.
Cerebrospinal fluid (CSF) leak. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/diseases/16854-cerebrospinal-fluid-csf-leak. Accessed September 28, 2021.
Epidural blood patch. University of Rochester Medical Center website. Available at: https://www.urmc.rochester.edu/imaging/specialties/procedures/epidural-patch.aspx. Accessed September 28, 2021.
Postdural puncture headache. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/postdural-puncture-headache. Accessed September 28, 2021.
So Y, Park JM, et al. Epidural blood patch for the treatment of spontaneous and iatrogenic orthostatic headache. Pain Physician. 2016;19(8):E1115-E1122.

Revision Information

  • Reviewer: EBSCO Medical Review Board Marcin Chwistek, MD
  • Review Date: 07/2021
  • Update Date: 09/28/2021