This prospective investigation was conducted to evaluate the efficacy
of different volumes of epidural blood patch (EBP) for treatment of po
stdural puncture headache (PDPH) in 81 consecutive patients. In the fi
rst part of the investigation (Study part 1), 10 ml of blood was injec
ted for EBP in 28 patients. In the second randomized part of the inves
tigation (Study part II), the patients were allocated to receive for E
BP either 10 ml (27 patients) or 10-15 ml (26 patients), according to
the height of the patient. The procedure was considered initially succ
essful if PDPH disappeared completely during the 2-h recovery room fol
low-up. To evaluate the long-term success, a questionnaire was mailed
to all patients. The EBP performed 3.7 +/- 2.9 days following the dura
l puncture was initially successful in 88-96% of the patients in the d
ifferent study groups. In the questionnaire, only 50-68% of the patien
ts reported that PDPH had disappeared immediately without recurrence.
In 16-36% of the patients the PDPH returned at lesser intensity and in
14-17% PDPH was reported to have continued, disappearing gradually in
all patients. Despite this, 87% of all patients were satisfied with t
he EBP treatment. There were no statistically significant differences
between the groups. The results indicate that a larger, height-adjuste
d volume of blood for EBP in adults does not produce a better effect o
n PDPH compared to a standard 10-ml volume. Despite the excellent init
ial effect (91%) seen in our patients, a permanent effect of the blood
patch was only achieved in 61%.