Lidocaine in the epidural space, through inhibitory effects upon coagulation, may contribute to inefficacy of epidural autologous blood patch (EBP). This study was undertaken to evaluate the effect of achievable epidural concentrations of lidocaine on blood coagulation as a step in testing this hypothesis. Ex vivo blood coagulation using whole blood (n = 20) was studied with computerized thromb...

We describe a patient who developed an immobilizing lumbovertebral syndrome after an extradural blood patch and who was hospitalized with a suspected extradural abscess. An infectious aetiology of the persistent backache could be excluded and the patient recovered with analgesics and physiotherapy. The probable aetiology is discussed.

Autologous "blood patching" has been used successfully for the treatment of persistent air leak in patients with spontaneous secondary pneumothorax. The case history is presented of a 19 year old woman with cystic fibrosis who developed tension pneumothorax following this procedure, with rapid clinical deterioration until the obstruction was cleared. To avoid this potentially fatal complication...

headache symptoms compared with patients administered blood patch, and should have been excluded from this analysis, in our opinion. Indeed, these women could be considered ‘treatment successes’, since they received analgesia sufficient to be able to continue childcare at home, headache-free at one week, without exposure to the risks of epidural blood patch. It follows that a similar proportion...

We describe a case in which homonymous hemianopsia developed abruptly following an epidural blood patch procedure. The procedure was performed in a patient complaining of post-dural puncture headache after an emergency Cesarean section under spinal anesthesia. Computed tomography and magnetic resonance imaging demonstrated that air bubbles had moved from the prepontine and premedullar cisterns ...

Post dural puncture headache (PDPH) can be observed after any trauma to the dura. The hallmark of PDPH is an increasing headache when assuming the upright position and improvement with the supine position. Diagnosis of PDPH is essentially based on history of dural puncture and clinical presentation. In most cases, if initial conservative therapies fail to provide the relief of symptoms, an epid...

In most cases of post-dural puncture headache, the positional symptoms will resolve spontaneously within 2 weeks. Conservative therapies include oral analgesics and hydration, bed rest, and abdominal binders. For refractory cases, an autologous epidural blood patch remains the treatment of choice. However, in certain cases the use of autologous blood for the blood patch may place the patient at...

Epidural blood patch is the standard treatment for postdural puncture headache when symptomatic therapy is ineffective. We report the cases of two patients who received an epidural injection of hydroxyethyl starch when an epidural blood patch was contraindicated; one due to Streptococcus agalactiae bacteraemia and one due to acute leukaemia. Relief of headache was achieved in both patients with...