Epidural blood patch: A narrative review.

Journal Article (Journal Article;Review)

The epidural blood patch (EBP) is one of the most effective treatments for intracranial hypotension. Anesthesiologists are familiar with performing EBPs for the treatment of dural puncture-associated intracranial hypotension following spinal anesthesia, complicated epidural analgesia, and diagnostic lumbar puncture. Increasingly, EBPs are used to treat patients with spontaneous intracranial hypotension. However, the treatment of these non-iatrogenic conditions presents new therapeutic challenges. The purpose of this narrative review is to discuss both procedural and diagnostic considerations of EBP for the various presentations of intracranial hypotension and allow the clinician to tailor treatment for the patient, especially in the setting of diagnostic dilemmas. After discussing EBP history and relevant anatomy, we review mechanisms of action and clinical indications for this intervention. The contraindications, complications, and treatment alternatives to the blood patch are examined in detail. Finally, objective methods to evaluate the effectiveness of the EBP, such as MRI or Doppler ultrasound, are presented as novel methods that may improve future diagnostic accuracy and treatment success.

Full Text

Duke Authors

Cited Authors

  • Zetlaoui, PJ; Buchheit, T; Benhamou, D

Published Date

  • October 2022

Published In

Volume / Issue

  • 41 / 5

Start / End Page

  • 101138 -

PubMed ID

  • 35952552

Electronic International Standard Serial Number (EISSN)

  • 2352-5568

Digital Object Identifier (DOI)

  • 10.1016/j.accpm.2022.101138

Language

  • eng

Conference Location

  • France