The management of dural puncture in obstetrics and the efficacy of epidural blood patches
Eustace, N.; Hennessy, A.; Gardiner, J.
Irish Medical Journal 97(10): 298-300
2004
ISSN/ISBN: 0332-3102 PMID: 15696874 Document Number: 566859
Epidural blood patch is the definitive treatment for post dural puncture headaches (PDH), providing acceptable short-term relief. Disappointingly however debate exists as to their long-term success. To investigate their efficacy in our practice, a retrospective audit of all epidural blood patches performed over a four year period was performed. Patients were subsequently followed up using a postal questionnaire and persistent symptom relief and patient satisfaction was measured. During the study period 87 patients required an epidural blood patch, 11 required repeat patches. 71.26% of patients had complete symptom resolution on discharge. The response rate to follow up survey was 73.26% with the majority, 57.44%, replying that their symptoms returned following their discharge home. Only 25.53% said they would have an epidural or spinal anaesthetic for future deliveries. Epidural blood patches provide excellent short-term relief but long-term results are disappointing. Patients receiving epidural blood patches need improved long-term follow up.