Effectiveness of Epidural Blood Patch in the Management of Post–Dural Puncture Headache

  title={Effectiveness of Epidural Blood Patch in the Management of Post–Dural Puncture Headache},
  author={Val{\'e}rie Safa-Tisseront and Françoise Thormann and Patrick Malassin{\'e} and M. Henry and Bruno Riou and Pierre Coriat and Jan Seebacher},
Background Lumbar epidural blood patch (EBP) is a common treatment of post–dural puncture headache, but its effectiveness and mode of action remain a matter of debate. The aim of this study was to assess both the effectiveness and the predictive factors of failure of EBP on severe post–dural puncture headache. Methods This prospective observational study includes all patients treated in the authors’ hospital with EBP for incapacitating post–dural puncture headache, from 1988 to 2000. The EBP… 
Epidural Blood Patch for the Management of Post-dural Puncture Headache
Epidural blood patch is an effective procedure in severe PDPH and Oral paracetamol and caffeine combinations and intravenous hydration are also effective in symptomatic treatment.
Long-Term Outcomes of Post Dural Puncture Headache Treated With Epidural Blood Patch: A Pilot Study.
It is demonstrated that patients who received an EBP for treatment of a PDPH following LP are no more likely to experience chronic headaches compared to patients who do not receive an EPs, however, both the EBP group and Non-EBP group had high incidence of chronic headaches.
WITHDRAWN: Epidural blood patching for preventing and treating post-dural puncture headache.
It was showed that, according to current evidence, clear conclusions cannot be drawn about the advantage of preventative epidural blood patch over other treatments, but the use of epiduralBlood patch after the onset of the headache showed benefit over conservative treatment.
Epidural blood patch in post dural puncture headache: a randomised, observer-blind, controlled clinical trial
EDBP is an effective treatment for PDPH and offers complete resolution of symptoms in a large proportion of patients, and in the remaining patients, it reduces headache severity and allows them to return to their everyday activities.
Post Dural Puncture Headache, Managed with Epidural Blood Patch, Is Associated with Subsequent Chronic Low Back Pain in Patients: a Pilot Study
The findings suggest that PDPH treated with an EBP is associated with an increased prevalence of subsequent low back pain in parturients.
Timing of epidural blood patch: clearing up the confusion
The authors concluded that prophylactic epidural blood patch reduces the incidence of PDPH after accidental dural puncture in obstetric patients and suggest that increasing the volume of blood injected may help to overcome dilutional effects of CSF.
Management of persistent post‐dural puncture headache after repeated epidural blood patch
  • K. HoT. Gan
  • Medicine
    Acta anaesthesiologica Scandinavica
  • 2007
A case of persistent post‐dural puncture headache (PDPH) in a patient despite two epidural blood patches (EBPs) is reported, with resolution of headache achieved with a third EBP performed under computed tomography (CT) guidance.
The Efficacy of a Fluoroscopy Guided Epidural Autologous Blood Patch In the Treatment of a Post-Dural Puncture Headache
In patients with PDPH, a fluoroscopy-guided EBP is an effective treatment and an additional EBP can be considered in the clinical failure or recurrence of PDPh after the first EBP.


Efficacy of epidural blood patch for postdural puncture headache
The results indicate that a larger, height–adjusted volume of blood for EBP in adults does not produce a better effect on PDPH compared to a standard 10–ml volume, and a permanent effect of the blood patch was only achieved in 61%.
Long‐Term Follow‐Up of Epidural Blood Patch
Epidural blood patch was found to be a safe, effective method for treating severe postlumbar puncture cephalalgia, provided a proper diagnosis is made and there is no contraindication.
Magnetic Resonance Imaging of Cerebrospinal Fluid Leak and Tamponade Effect of Blood Patch in Postdural Puncture Headache
This study suggests that using MRI, the site of the CSF leak, the tamponade effect of the blood patch, and its spread in the epidural space can be documented.
Unintentional dural puncture and prophylactic epidural blood patch in obstetrics.
A prospective sequentially randomized study to compare the efficacy of a prophylactic epidural blood patch (PEBP) with conservative measures in preventing PDPH in obstetrical patients.
Seven-year review of requests for epidural blood patches for headache after dural puncture: referral patterns and the effectiveness of blood patches.
Epidural blood patches are effective in treating headache after dural puncture, but less successful than is commonly believed, especially after inadvertent dural taps.
Epidural blood patch: a rapid coagulation response.
A rapidity of clotting is observed more in keeping with the nearly immediate relief of spinal headache treated with epidural blood patches, and it is suggested that there may be coagulation at this interface of blood and CSF that causes almost instantaneous formation of a plug.
Duration of decubitus position after epidural blood patch
It is concluded that epidural bloodPatch was effective in treating PDPH but that the maintenance of a decubitus position for at least one hour and preferably for two hours after the blood patch was more effective than maintenance for 30 min.
Postdural Puncture Headache and Spinal Needle Design: Metaanalyses
It is concluded that a noncutting needle should be used for patients at high risk for PDPH, and the smallest gauge needle available should been used for all patients.
Cervical dural puncture and lumbar extradural blood patch
It is concluded that extradural injection of autologous blood at the same level of the durai puncture may not be necessary and the injection épidurale de sang autologue au même niveau that the ponction peut ne pas être nécessaire.
Visualization of extradural blood patch for post lumbar puncture headache by magnetic resonance imaging.
MRI demonstrated a large extradural haematoma extending over four spinal segments and extending out through the neural outlet foramina, supporting the theory that extradural blood patch causes tamponade at the site of dural puncture.