Epidural Blood Patch for Spinal Headache

What is Epidural Blood Patch for Spinal Headache

An epidural blood patch is a procedure that is used to treat a headache that happens when there is a leak of spinal fluid. This type of headache is called a spinal headache or a post-dural puncture headache.

Spinal headaches sometimes happen after a person is given a type of anesthesia called epidural anesthesia or after the person has a lower back (lumbar) puncture.

Generally, an epidural blood patch is done when a spinal headache has not been helped by 2–3 days of:

• Resting in bed.
• Drinking lots of fluids.
• Taking medicines by mouth for pain.

An epidural blood patch is not done when:

• Your headache is because of an infection in your lumbar area or in your blood.
• You are prone to bleed too much (have bleeding tendenciesor bleeding disorders).
• You are taking certain blood-thinning medicines.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, an epidural blood patch is a safe procedure. However, problems may occur, including:

• Backache.
• Nerve pain, tingling, or numbness.
• Bleeding.
• Infection.

There may be added health problems in people who have bleeding disorders or infections.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

Ask your health care provider about:

• Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
• Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do nottake these medicines before your procedure if your health care provider instructs you not to.

General instructions

• Plan to have someone take you home from the hospital or clinic.

What happens during the procedure?

• You will have two IV lines, or tubes, placed. One will give you fluids and medicines during the procedure. The other will be used to take blood.
• You will be asked to lie on your abdomen.
• An X-ray machine will take pictures of your back to show where the leaking is.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
• A dye may be injected so the area can be seen well on an X-ray, or an ultrasound may be done to locate the area.
• Blood will be drawn from your arm and injected into the place in your body where the leak is. When the blood is injected, you may feel tightness in your buttocks, lower back, or thighs.
• The IV lines will be removed.
• A bandage (dressing) will be put over the area where the IV lines were.

What happens after the procedure?

• Your headache may be gone almost right away, or the headache may go away more slowly over the next 24 hours.
• You will be asked to lie on your back for 2–4 hours with some pillows under your knees. It is important to lie still while on your back so a good clot can form.
• Avoid any straining, especially right after the procedure.
• You may have a mild backache, a feeling of prickly or tingly skin (paresthesia), neck pain, or pain down your arm or leg (radiating pain).
• Do notdrive for 24 hours if you received a sedative.

Care After Epidural Blood Patch for Spinal Headache

These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions.

Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Almost-instant relief from your headache, or have slowly easing pain over the next 24 hours.
• Mild backaches. These may last for a few days.
• A mild feeling of prickly or tingly skin.
• Neck pain.
• Pain down the arm or leg (radiating pain).

Follow these instructions at home:

• For the first 24 hours after the procedure:
  • Do notdrive if you received a medicine to help you relax (sedative).
  • Rest in bed as much as you can.
• For 2–3 weeks, do notlift anything that is heavier than 10 lb (4.5 kg).
• When picking up items from a low position, squat rather than bend.
• Avoid too much straining. This can cause the patch to move out of position and cause the headache to return.
• Drink enough fluids to keep your urine clear or pale yellow.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever.
• You have back pain.
• You have pain that goes down your legs.
• Your headache comes back.
• You have trouble with your bowels or bladder.

Get help right away if:

• You have a very bad headache.
• You have nausea or vomiting.