Abstract
Objective: Spinal anesthesia has some complications such as intravascular injections, nerve injuries, hypotension, bradycardia and dural ruptures. When puncture is performed on dura or araknoid, there is a risk of post-dural-puncture headache. Material and Methods: 16003 patients, who were operated at the Erzincan State Hospital and Erzincan Mengucek Gazi Education and Research Hospital between 2004 and 2011 were involved in this study. Epidural blood patch was applied on 159 patients complaining of post-dural-puncture headaches. 15 ml of the autologous blood was given to the epidural region in the surgery room for patients which had epidural blood patch applied. Epidural blood patch was applied 2 days after the dural injury Results: 72 females and 67 males were involved in the study. Symptoms of post-dural-puncture headache disappeared within minutes immediately after the process. After the first application of epidural blood patch, 156 patients felt relaxed. 3 patients had a relief after the first application, but their symptoms relapsed, and a second injection was performed 24 hours after the first one. Following the second epidural blood patch, none of the patients reported any headaches. No complications emerged during the procedure in the patients. The patients were discharged 2-3 hours after the epidural blood patch application. Discussion: Epidural blood patch is a treatment method with lower risks of complications, lower costs and high success rate for post-dural-puncture headache patients. It is advised especially after the C-section, for preserving mother-baby communication.
Highlights
Spinal anesthesia has some potential advantages over general anesthesia and it has been widely and successfully used for nearly 100 years, especially in surgeries of lower abdomen, perineum and lower extremities [1]
Epidural blood patch was applied on 159 patients complaining of post-dural-puncture headaches. 15 ml of the autologous blood was given to the epidural region in the surgery room for patients which had epidural blood patch applied
Symptoms of post-dural-puncture headache disappeared within minutes immediately after the process
Summary
Spinal anesthesia has some potential advantages over general anesthesia and it has been widely and successfully used for nearly 100 years, especially in surgeries of lower abdomen, perineum and lower extremities [1]. Spinal anesthesia is an alternative to general anesthesia in most cases. It was shown that with an appropriate approach, neuroaxial anesthesia methodologies are highly safe, but there can be some complications emerging during and after the procedure. Some of these complications are intravascular injections, nerve injuries, hypotension, bradycardia and dural rupture [6,7]. Post-dural-puncture headache is the most common complication of the regional block anesthesia and it is an important condition caused by the leakage of the cerebral spinal fluid (CSF) from the hole opened by the needle during dura puncture and related to CSF pressure[8]
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