Procedure: Blood Patch
What is a Blood Patch?
It is an injection of autologous (the patient’s own) blood into the epidural space to “patch” one or more holes in the dura mater (sheath surrounding the spinal cord).
What is the purpose of it?
A blood patch is done to provide headache relief caused by the leaking of cerebral spinal fluid into the epidural space after a lumbar puncture. Once the blood is injected, the clotting factor of the blood closes the hole in the dura.
How long does the injection take?
The procedure takes approximately 20-30 minutes, but plan to be in the office for two to three hours. This allows for the patient's pre-op and recovery time as well. The driver must remain in the building during the procedure.
What is actually injected?
The injection is approximately 15-20ml of the patient's blood. The blood is taken from the arm during the procedure and then injected into the epidural space.
Will the injection hurt?
The procedure involves inserting a needle through the skin and deeper tissue (like a tetanus shot). While there is some discomfort involved, the skin and deeper tissues are numbed with a local anesthetic using a very thin needle prior to inserting the epidural needle. The tissue in the midline of the spine has less nerve supply, so usually patients feel strong pressure and not much pain. Monitored Anesthesia Care (MAC) makes the procedure easy to tolerate.
How is the injection performed?
The procedure is done with the patient lying on their stomach under live x-ray. The patient may be monitored with an EKG, blood pressure cuff, and blood oxygen monitoring device. The area to be injected is cleaned with antiseptic solution and then the injection is performed. An additional IV will be started during the procedure to collect the blood needed for the injection.
What should I expect after the injection?
Often relief is immediate, but it can sometimes take one to two days for all symptoms to completely disappear. The patient may also feel sore for two to three days. This is due to the mechanical process of needle insertion as well as initial irritation from the steroid itself.
What should I do after the injection?
The patient will be monitored for approximately an hour after the procedure and discharge shortly after that. They should have a driver to take them home. Coastal Bend Pain Management advises the patient to take it easy for a day or two after the procedure and they should be able to return to work in one to two days. Be sure to drink plenty of fluids and avoid strenuous activities.
Will the Blood Patch help me?
Most patients who have had their “spinal headache” for more than 24 hours tend to have better relief than those whose headache has recently started.
What are the risks and side effects?
Generally speaking, this procedure is safe. However, with any procedure there are risks, side effects, and possibility of complications. The most common side effect is pain – which is temporary. Other side effects include unintentional puncture of the spinal fluid containing "sack", bleeding, no alleviation of the headache, increased pain due to the injection, infection, and nerve damage.
Who should not have this injection?
If the patient is allergic to any of the medications to be injected, if they are on a blood thinning medication (ex: Coumadin, Plavix), if they have an active infection going on, the patient should not have the injection.