Epidural Blood Patch
Procedure
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).
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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
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.
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
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.
American College of Obstetricians and Gynecologists
Family Doctor—American Family Physician
CANADIAN RESOURCES:
Canadian Anesthesiologists’ Society
The Society of Obstetricians and Gynecologists of Canada
American College of Obstetricians and Gynecologists
Family Doctor—American Family Physician
CANADIAN RESOURCES:
Canadian Anesthesiologists’ Society
The Society of Obstetricians and Gynecologists of Canada
References
- Anesthesia epidural blood patch. UW Health website. Available at: https://patient.uwhealth.org/healthfacts/6098.
- Cerebrospinal fluid (CSF) leak. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/diseases/16854-cerebrospinal-fluid-csf-leak.
- Epidural blood patch. University of Rochester Medical Center website. Available at: https://www.urmc.rochester.edu/imaging/specialties/procedures/epidural-patch.aspx.
- Postdural puncture headache. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/postdural-puncture-headache.
- 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.
Contributors
- Marcin Chwistek, MD
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