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Canadian Journal of Anesthesia, Vol 41, 628-631, Copyright © 1994 by Canadian Anesthesiologists' Society

ARTICLES

Exacerbation of post-dural puncture headache after epidural blood patch

WM Woodward, DM Levy and AM Dixon
University Department of Anaesthetic and Surgical Sciences, Royal Hallamshire Hospital, Sheffield.

The purpose of this report is to describe a new complication of epidural blood patch for inadvertent dural puncture. A dural tap in an obstetric patient was managed initially with a prophylactic blood patch via the epidural catheter. Despite this, 48 hr later, she developed post-dural puncture headache, neck, and shoulder pain, and was given a second epidural blood patch. This was followed by an immediate and severe exacerbation of her symptoms, which later resolved after the administration of diclofenac. There were no further sequelae. Although severe complications of epidural blood patch are rare, they are alarming. Exacerbation of the original symptoms of post-dural puncture headache caused by, or following, epidural blood patching has not previously been reported.


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Copyright © 1994 by the Canadian Anesthesiologists' Society.