Epidural Blood Patch

A minimally invasive treatment to treat a dural puncture

The dura is a membrane that surrounds the spinal cord. In some medical treatments, such as an epidural steroid injection, the dura can be punctured accidentally. This can lead to a number of symptoms, such as:

• Headache that is worse when sitting or standing but better when lying down
• Loss of hearing
• Nausea
• Neck stiffness
• Ringing in ears
• Sensitivity to light

Many cases of dural puncture get better on their own with bedrest, increased fluid intake, and pain-relieving medication. If your dural puncture hasn’t improved with these treatments, however, we can treat it with an epidural blood patch. This procedure involves injecting a small amount of your blood into the epidural space (the space inside the spinal column that contains the spinal cord and nerve roots). The blood clot that forms will patch the leak in your dura.

There is a small risk of complications from an epidural blood patch. Complications can include:

• Dural puncture with headache
• No relief of your headache
• Temporary back pain

Pain Management Service, Newton-Wellesley Ambulatory Care Center
159 Wells Avenue
Newton, MA 02459
Phone: 617-243-6142

What to Expect From Your Epidural Blood Patch

When you arrive for your procedure, one of our nurses will speak with you about what your pain is like and how you manage daily activities. We’ll record the following vital health information:

• Allergies
• Blood pressure
• Brief health history
• Medications you’re currently taking
• Pulse
• Temperature
• Weight

It’s especially important to tell your nurse if you:

• Are allergic to contrast dye, Betadine (iodine), or latex
• Could be pregnant
• Currently take blood thinners

Next, you’ll discuss the procedure with your doctor, and we’ll start an intravenous (IV) line in your arm. Next, you’ll go into the X-ray room, where we’ll help you onto a table. Once you’re comfortable, we’ll clean your skin with an antiseptic and numb it with a local anesthetic. Your doctor will use X-ray guidance to place a small needle into the epidural space of your spine. Once the needle is in place, we’ll take blood from your IV line and pass it through the needle in your spine. The entire procedure will take only a few minutes.

You should plan to stay with us for a couple of hours after your procedure. During this time, we’ll give you fluids through your IV line, as well as caffeinated drinks. A nurse will go over any questions you may have and review your discharge instructions and required follow-up care. You will need a ride home after your procedure.

When You Go Home After Your Epidural Blood Patch

We recommend bed rest for the first 24 hours after your procedure. You may get up for meals and to use the bathroom. For the next 48 to 72 hours afterward, avoid the following activities, which can dislodge your blood patch:

• Any strenuous activity
• Coughing
• Lifting more than 10 pounds
• Quick or sudden movements
• Sneezing

Place ice on your injection site to ease any pain. You can resume your normal diet afterward, but make sure to drink plenty of liquids.

Please call us at 617-243-6142 to tell us how you respond to your epidural blood patch. You should report any of the following:

• Fever
• Increase in your discomfort or pain
• Leg weakness
• Loss of bladder or bowel control

Talk to your doctor for more information about receiving a referral for an epidural blood patch, or call us at 617-243-6142 to request an appointment.