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Epidural Blood Patch

A blood patch is an effective way to stop a headache that has been caused by a spinal procedure, such as a lumbar puncture (spinal tap or a myelogram) or placement of an epidural catheter.

An injection of a freshly drawn sample of blood from a vein in your arm is placed back into the epidural space. This most often causes the headache to go away immediately.

Procedure overview (PDF) ›

Patient guidelines (PDF) ›

What is the goal of a blood patch?

The goal of an epidural blood patch is to provide pain relief so that you are able to resume normal activities.

What happens before treatment?

You will be escorted to a room where a nurse will conduct a pre-procedure interview.

The physician who will perform the injection reviews your medical history, previous imaging studies, current medications and physical exam results in order to help plan the best approach for the injection. If you have not had a physical exam prior to the injection, the physician will perform an exam at this time.

What happens during the procedure?

You will remain awake during the entire process. Blood pressure, heart rate and breathing are continually monitored.

After you are lying face down on the procedure table, the injection site is cleansed with an antiseptic. This procedure involves inserting a needle through the skin, muscle and soft tissues, so there is some slight discomfort involved.

An injection of local anesthetic (numbing medication) will be administered in the area where you are experiencing pain. The physician then directs a needle with the use of X-ray guidance and deposits the medication.

This procedure takes approximately 30 minutes.

Should I limit my activity or change my diet after the injection?

No. Unless your doctor tells you otherwise, you may return to your usual activities.

Are there any side effects caused by a blood patch?

Side effects are uncommon following an injection; however, you may experience the following:

  • Immediately after the injection, you may feel that your pain is gone or is much less. This pain relief is often the result of the local anesthetic and will usually only last a few hours. Your usual pain will follow. Pain relief from the steroid medication usually takes several days to appear.
  • You may experience mild pain at the site of injection for several days. You may also experience a temporary increase in your usual pain after the injection. You can apply ice to the area for as long as 15 minutes, three to four times a day.
  • You may experience some dizziness during or soon after the injection.

Are there any restrictions after a blood patch?

Yes. You should follow these restrictions:

  • Do not drive for the remainder of the day.
  • Do not take a tub bath or soak in water (i.e. pool, hot tub) for 24 hours after the procedure.
  • Allow three days post-procedure before resuming physical therapy.

What are the medications used for a blood patch?

  • Lidocaine or bupivacaine are local anesthetics that are used to numb the area of injection; this numbness usually wears off within two to six hours.
  • Iopamidol, an X-ray contrast agent is injected into the area to confirm correct placement of the blood sample.

When should I call my doctor?

You should call us immediately if any of the following occur:

  • If you experience any swelling, redness, bleeding or discharge from the site of the injection
  • If you have a fever greater than 100˚F
  • If you experience new or worsening back or neck pain
  • If you experience a new numbness or weakness in your arms or legs
  • If you experience any chest pain or shortness of breath or persistent cough
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