Blood is taken from your arm and injected into your back, near to the hole in the dura. This injection is similar to having the original epidural or spinal injection. The blood will clot and tend to plug the hole.

Who will perform the procedure?

An anaesthetist

Why do I need it?

A blood patch may be needed if you have a severe headache after a spinal or epidural. Severe headaches are caused by low pressure in the spinal canal.

What preparation is needed?
  • Tell your healthcare team about any allergies and all of the medicines you take. Be sure to include all prescriptions, over-the-counter remedies (allergy pills or cough syrup), patches, vitamins, herbs or blood thinners.
  • Your doctor will make sure you don’t have an infection. If you do, the procedure will be delayed. (Since the procedure uses your own blood, this check helps make sure an infection in your blood won’t spread.)
  • If you’re not staying in the hospital, you’ll need to arrange for transport back home.
How is the test carried out?

Preparing the site (your back): You will be asked to lie on your side or sit on the edge of a bed or table. The doctor will carefully clean your back and apply local anaesthetic (numbing medicine).

Drawing blood: A small amount of your blood will be taken, probably from a vein in your arm by another doctor.

Insertion: The doctor will insert a thin needle into your back and will guide it to the area of the CSF(spinal fluid) leak. You’ll be asked to keep very still during this part of the procedure. The blood will be injected into your spine. If you feel any back or leg pain, let the doctor know. As the blood clots, it should seal the leak.

Post procedure
  • After the blood patch is placed, you’ll need to stay in the hospital for a short time so that the medical team can monitor you. 
  • You will need to lie flat for approximately 2 hours.
  • Before you go home, the team may do some repeat checks to make sure you’re doing well.
  • Before you go home, the team may do some repeat checks to make sure you’re doing well.
  • In some patients, the headache will resolve almost immediately; sometimes it may take a few hours or overnight to resolve.
Are there any complications with the procedure?
  • Repeat dural puncture
  • Back pain and/or neck pain during an EBP may occur in 50% of women. 80% of women may have pain 24 hours after the procedure. This may continue for several days, but severity usually decreases over a few days with resolution by four weeks in most cases. Chronic back pain is not related to EBP.
  • Neurological complications like nerve injury, infection are very rare.
The following are NOT normal after epidural blood patch:
  • Difficulty in passing urine
  • Severe back pain 
  • Loss of sensation in your back or legs

 If you experience any of the above symptoms contact your anaesthetist or emergency services immediately.

What is the success rate of the procedure?

Overall, complete or partial relief may be seen in 50-80% of patients. Sometimes relief of headache may require a second blood patch.

Post procedure care at home
  • For the first 24 hours after the procedure, don’t drive.
  • Don’t lift anything heavy or do any vigorous exercise.
  • You may take a shower, but don’t take a bath, use a hot tub or go swimming.
  • For a few days, your back may feel stiff and sore.
  • Drink plenty of fluids.
  • Watch for signs of infection.
  • Call the contact number provided right away if you notice any of the following:
  • Fever or chills
  • Increased redness, swelling around the blood patch site, or any fluid drainage from the site
  • Extremely stiff neck
  • Problems thinking clearly
  • You may need someone at home to help you with your daily activities.
What if I still have a headache?

 In cases of partial or no relief a second EBP may be considered after ruling out other causes of headache.

Does an EBP affect my future spinals/epidurals?

Current evidence is insufficient to comment on whether an EBP affects outcomes of subsequent spinal/epidurals, but do make the anaesthetist aware if you have had an EBP done previously.

For more information/ emergency, contact:

Labour suite: 01228 814266

Anaesthetic department secretary: 01228 814196 (Monday to Friday, 8:30 to 16:30)

Out of hours: Anaesthetist on call (page #246) via switchboard 01288 523444
 

Confidentiality

‘The Trust’s vision is to keep your information safe in our hands.’ We promise to use your information fairly and legally, and in-line with local and national policies. You have a right to understand how your information is used and you can request a copy of the information we hold about you at any time.

For further information on confidentiality contact the Information Governance Team:

Information.Governance@ncic.nhs.uk | 01228 603961

Feedback

We appreciate and encourage feedback, which helps us to improve our services. If you have any comments, compliments or concerns to make about your care, please contact the Patient, Advice & Liaison Service:

pals@ncic.nhs.uk | 01228 814008 or 01946 523818

If you would like to raise a complaint regarding your care, please contact the Complaints Department:

complaints@ncic.nhs.uk | 01228 936302