EFFICACY OF EPIDURAL BLOOD PATCH FOR POSTDURAL PUNCTURE HEADACHE

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%.