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Canadian Journal of Anesthesia, Vol 42, 625-627, Copyright © 1995 by Canadian Anesthesiologists' Society

ARTICLES

Caudal epidural blood patch for the treatment of a paediatric subarachnoid-cutaneous fistula

MA Kowbel and VK Comfort
Department of Anaesthesia, Royal University Hospital, Saskatoon, Saskatchewan.

This clinical report describes the performance of an epidural blood patch in a four-year-old child with acute lymphocytic leukaemia, who developed a subarachnoid-cutaneous fistula from repeated lumbar punctures for chemotherapy. The epidural blood patch was performed using an #18-gauge epidural catheter threaded through a #16-gauge intravenous catheter via the caudal approach. This approach was successful in a child whose lumbar epidural anatomy was distorted due to a collection of subcutaneous cerebrospinal fluid making identification of the epidural space by the usual lumbar approach very difficult. This report demonstrates an alternative technique for the performance of an epidural blood patch.


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Copyright © 1995 by the Canadian Anesthesiologists' Society.