Epidural Blood Patch Information for Patients WW.10.01A

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Epidural Blood Patch Information for Patients WW.10.01A

Transcript Of Epidural Blood Patch Information for Patients WW.10.01A

EPIDURAL BLOOD PATCH INFORMATION
INFORMATION FOR PATIENTS
What is an epidural blood patch?
An epidural blood patch is an injection of your blood into the epidural space. The epidural space is not an injection into the spinal cord itself. The spinal cord and spinal nerves are in a “sack” containing clear fluid (cerebrospinal fluid). The area outside this “sack” is called the epidural space.
Why is it done?
There are certain conditions under which patients will have had injections in the spinal column. Examples include an epidural during labour, a diagnostic spinal tap, a therapeutic spinal injection, etc. A small number of patients will experience a severe headache after the procedure, usually worse with standing and better when lying down. This is due to a persistent leak of spinal fluid into the epidural space. Although the headache itself is harmless, it can be very severe and very debilitating. Your doctor may ask you to come to our clinic for an “epidural blood patch”. The injection of a freshly drawn sample of your own blood into the epidural space “plugs the leak” and the headache goes away.
How long does it take to do?
The actual injection takes only a few minutes. Please allow about two and a half (2 1/2) hours for the procedure; this will include signing the informed consent, the actual and observation by the recovery room nurse afterwards.
What medicines are injected?
You may be given some pain medication intravenously just before the procedure to help with the headache. Other than that, it is just local anesthetic to numb your skin.
Will it hurt?
All of the procedures begin by injecting a small amount of local anesthetic through a very small needle. It feels like a little pinch and then a slight burning as the local anesthetic starts numbing the skin. After the skin is numb, the procedure needle feels like a bit of pressure at the injection site. If you experience any pain during the procedure, your doctor will inject more local anesthetic as needed.
How is it done?
It is typically done with you sitting up, and performed in the same way as your labour epidural. Your blood pressure and oxygen levels will be monitored. A separate area where a good vein is available is also cleaned with antiseptic solution. A small intravenous catheter is placed in the vein. After your doctor has placed the epidural needle near the affected area, your nurse will draw about 25 cc (millilitres) of blood from your vein and give it to the doctor. The doctor will then gradually inject the blood until you feel severe pressure in the back. Typically, about 15 -25 cc are injected.

WW.10.01A

Fetal Maternal Newborn and Family Health Policy & Procedure Manual Refer to online version – Print copy may not be current – Discard after use

Effective Date: 16 July 2012 Page 1 of 2

EPIDURAL BLOOD PATCH INFORMATION
What should I expect after the injection?
Immediately after the injection, you may feel pressure in the back. This is due to the effect of the blood in the epidural space. After resting for about 90 minutes, you will slowly sit up to 90 degrees and eventually be asked to stand up. Typically, most patients experience significant relief immediately. After a few hours, your body will have had a chance to replenish the lost spinal fluid and your headache should continue to get better.
What should I do after the procedure?
Try to avoid straining at all, this includes bending over and picking up heavy objects, with bowel movements, coughing and blowing your nose hard. You should avoiding travelling in an airplane for a few weeks if possible.
Can I go back to work the same day or the next day?
You should not go back to work the same day. By the next day, most patients will be able to although you might need an extra day to recover.
How long does it last?
The epidural blood patch is permanent. After the injection of your blood, the body’s own healing system should take over and finish repairing the spinal fluid leak. However, only 65% of patients are symptom free at 5 days after the patch. Of this, only some require a second patch as the headache is usually not as severe as it was initially.
What are the risks and side effects?
Overall, this procedure has very few risks. However, as with any procedure, there are some risks and side effects you should know about. Commonly encountered side effects are increased pain from the injection (usually temporary), inadvertent puncture of the “sack” containing spinal fluid (may not relieve your headaches), infection, bleeding, nerve damage, or no relief from your headache. Some patients have persistent low back pain for several days.
Who should not have this injection?
The following patients should not have this injection: if you have a temperature or any neurological symptoms.
Please contact the Department of Anesthesia at BC Women’s if you have any questions or concerns, such as return of the headache. An anesthesiologist is available on a pager 24 hours a day.
Call 604 875-2158 during office hours Monday to Friday 7:30 am to 3:30 pm. After hours call the hospital 604 875-2424 and ask to speak to the anesthesiologist on-call.
Department of Anesthesia, BC Women’s

WW.10.01A

Fetal Maternal Newborn and Family Health Policy & Procedure Manual Refer to online version – Print copy may not be current – Discard after use

Effective Date: 16 July 2012 Page 2 of 2
InjectionProcedureHeadachePatientsBlood