Prophylactic blood patch performed prior to continuous epidural analgesia.
Two cases of inadvertent dural puncture in patients at high risk for dural puncture headache are presented. These patients were managed with an immediate epidural blood patch through a catheter placed at another level with placement of this catheter occurring immediately following the dural puncture. Following the blood patch, the patients were anesthetized with the epidural catheter being used for supplementation of the general anesthetic and for postoperative pain management. Neither patient required further management of a dural puncture headache nor did it appear that the blood interfered with the patients receiving adequate postoperative analgesia through the use of this epidural catheter.
Waters
J H
JH
Department of General Anesthesiology, Cleveland Clinic Foundation, 9500 Euclid Avenue/E31, Cleveland, OH 44195, USA. watersj@ccf.org
Sabharwal
V
V
Grass
J A
JA
D000293:Adolescent; D000328:Adult; D015360:Analgesia, Epidural; D017217:Blood Patch, Epidural; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged