Best time for the application of the "blood patch" technique for post-spinal anesthesia headache: a systematic review

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Authors

  • Ana Letícia Borghetti Atitus University. Passo Fundo. Rio Grande do Sul. Brazil
  • Alan Christmann Fröhlich Neurology and Neurosurgery Service. Passo Fundo. Rio Grande do Sul. Brazil https://orcid.org/0000-0003-1932-7452

DOI:

https://doi.org/10.48208/HeadacheMed.2025.4

Keywords:

Headache, Blood patch, Application, Efficacy

Abstract

Introduction

With the puncture of the dura mater during spinal anesthesia, excessive cerebrospinal fluid (CSF) leakage can occur, leading to intracranial hypotension and, consequently, post-dural puncture headache. Currently, there are symptomatic supportive treatments, but they do not provide complete relief. The epidural blood patch has emerged as a treatment option with proven success, but there are still questions about the best timing for its use.

Objective
To identify the best timing for the application of the epidural blood patch.

Method
Systematic review of clinical trials and randomized clinical trials on PubMed from 2000 to 2023.

Results
The review of the articles covers various topics on the use of the blood patch, including its effectiveness, comparison with conservative treatment, volume applied, timing of application, duration of supine positioning due to pain incapacity, and needle size. However, data regarding the timing of application were not extensively highlighted.

Conclusion
It was not possible to accurately determine the best timing for the application of the technique due to the lack of data, but its effectiveness is well-known, requiring further studies to better prescribe this treatment.

 

 

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References

Olawin AM, Das JM. Spinal Anesthesia. 2025.

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Turnbull DK, Shepherd DB. Post-dural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth 2003;91:718–29. Doi:10.1093/bja/aeg231. DOI: https://doi.org/10.1093/bja/aeg231

van Kooten F, Oedit R, Bakker SLM, Dippel DWJ. Epidural blood patch in post dural puncture headache: a randomised, observer-blind, controlled clinical trial. J Neurol Neurosurg Psychiatry 2008;79:553–8. Doi:10.1136/jnnp.2007.122879. DOI: https://doi.org/10.1136/jnnp.2007.122879

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Safa-Tisseront V, Thormann F, Malassiné P, Henry M, Riou B, Coriat P, et al. Effectiveness of Epidural Blood Patch in the Management of Post–Dural Puncture Headache. Anesthesiology 2001;95:334–9. Doi:10.1097/00000542-200108000-00012. DOI: https://doi.org/10.1097/00000542-200108000-00012

Vilming S, Kloster R, Sandvik L. When Should an Epidural Blood Patch be Performed in Postlumbar Puncture Headache? A Theoretical Approach Based on a Cohort of 79 Patients. Cephalalgia 2005;25:523–7. Doi:10.1111/j.1468-2982.2005.00911.x. DOI: https://doi.org/10.1111/j.1468-2982.2005.00911.x

Hachimi MA, Elkartouti A, Rafik R, Jaafari A, Hannafi M, Mahmoudi A. Le blood-patch : un remède d’efficacité immédiate pour les céphalées secondaires aux brèches dure-mériennes. Ann Fr Anesth Reanim 2009;28:748–50. Doi:10.1016/j.annfar.2009.07.070. DOI: https://doi.org/10.1016/j.annfar.2009.07.070

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Published

2025-03-30

How to Cite

1.
Borghetti AL, Fröhlich AC. Best time for the application of the "blood patch" technique for post-spinal anesthesia headache: a systematic review. Headache Med [Internet]. 2025 Mar. 30 [cited 2025 Apr. 2];16(1):23-7. Available from: https://headachemedicine.com.br/index.php/hm/article/view/1335

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Review

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