Epidural Blood Patch
An epidural blood patch is used to relieve headaches caused by lumbar puncture (spinal tap). Sometimes, after a lumbar puncture, spinal fluid can leak, decreasing the pressure of the spinal fluid. This low pressure causes a headache. A headache after a lumbar puncture can cause severe pain with standing or sitting, and no pain with lying flat. If you think you have a low-pressure headache, your doctor may first instruct you to rest, lie flat, and drink plenty of fluids. If this does not help, your doctor may refer you for an epidural blood patch.
An epidural blood patch places your own blood in the spinal canal close to the same site where the lumbar puncture was performed. This should seal the leak of spinal fluid and relieve the headache.
- You cannot take aspirin (this includes baby aspirin) for 1 week before the blood patch. If you take aspirin for your heart or blood vessels as prescribed by your doctor, you will need a written note from your doctor saying it is ok to stop.
- You cannot take Plavix® (clopidogrel) for 10 days before the blood patch. You will need a written note from your doctor saying it is ok to stop taking your Plavix®.
- Call your family doctor if you take blood thinners such as heparin or Coumadin® (warfarin). Your blood tests must be normal before we do the blood patch.
- You cannot take anti-inflammatory drugs 1 day before the blood patch. These include: Advil®, ibuprofen, edtodolac, indomethacin, naproxen, Aleve®, Feldene®, diclofenac, Mobic®, and piroxicam. You do not need to quit taking Celebrex®. If you are not sure about the drugs you are taking, ask your doctor.
- You cannot take herbals, fish oil, or Vitamin E for 3 days before the blood patch.
- You must be healthy on the day we do the blood patch. You cannot have a cold, flu, rashes, or other infections. If you are feeling sick or have a cold please let us know. Please try to call 24 hours or more before the procedure.
- Do not eat solid food for 6 hours or drink liquids 2 hours before your patch. You may take a sip of water if you need to take medicine.
- Take your usual medicines unless you are told not to.
- Tell us if you have any drug allergies or if you have had problems with X-ray dyes (contrast dyes), iodine, Betadine, seafood, shellfish, latex, or local anesthetics (numbing medicine).
- Make sure someone is able to drive you home. You can not drive yourself home.
- Call (608) 265-1770 if you have any questions, or want to cancel the blood patch.
What to Expect
You will be brought to a prep room. You will change into a hospital gown and 2 IVs will be started in your arms. One is for medicines and fluids, and the other is for drawing your blood. You will be asked questions about your health history, current health, and current medicines. You will also fill out a pain diagram. We will go over the consent form with you. We will explain what we are going to do, why, and any side effects that could happen. If you have any questions, they will be answered at this time. Your family and friends can be with you before and after the blood patch, but not in the procedure room.
We will place the blood patch in an operating room with an X-ray machine. You may be given a drug to relax you , if needed, but you will remain awake.
You will lie face down on a table. We will watch your blood pressure, heart rate, and how well you are breathing while the blood patch is placed. We will use pillows to help position you and make you comfortable. Your back will be washed and covered with a sterile drape. Using the X-ray machine, your doctor will guide a thin needle into your back very close to where the lumbar puncture was performed. Your doctor will inject some X-ray (contrast) dye through the needle to make sure that the needle is in the right place. X-rays will be taken. A small amount of your blood will be drawn and immediately injected into your back. You will be asked to lie very still. If you feel any back or leg pain, let your doctor know. The procedure takes about 30 minutes.
After the blood patch is placed, you will go to the recovery room where nurses and your doctor will watch you for at least an hour. You will lie flat at first, and then you can slowly sit up. You will be given IV fluids. The nurses will make sure you have something to eat and drink. Before you go home, you will be checked briefly to make sure you are doing OK. Most of the time, your headache will be gone by the time you leave.
Your driver will take you home. You may not drive for 24 hours. If you were given a drug to relax you, you should not make important personal or business decisions until the next day.
Once home, you should take it easy. Your back may feel stiff and sore for a few days. Avoid any heavy lifting or intense physical activity for 24 hours. Drink plenty of fluids. No swimming or tub baths for 24 hours. Taking a shower is OK.
Watch for signs of infection
- Fever greater than 100.4° F by mouth for 2 readings taken 4 hours apart
- Increased redness, swelling around the blood patch site
- Any drainage from the site
- Severe stiff neck, problems thinking clearly
If you have any problems, new symptoms, or signs of infection, please call (608) 265-1770.
After hours, nights and weekends, call (608)-262-0486 or you live out of the area, call 1-800-323-8942. Ask for the rehabilitation doctor on call. Leave your name and phone number with the area code. The doctor will call you back.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 01/30/2013
Copyright © 12/27/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6098
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