Prophylactic blood patch performed prior to continuous epidural analgesia

Two cases of inadvertent dural puncture in patients at high risk for dural puncture headache are presented. These patients were managed with an immedi ate epidural blood patch through a catheter placed at another level with pl acement of this catheter occurring immediately following the dural puncture . Following the blood patch, the patients were anesthetized with the epidur al catheter being used for supplementation of the general anesthetic and fo r postoperative pain management. Neither patient required further managemen t of a dural puncture headache nor did it appear that the blood interfered with the patients receiving adequate postoperative analgesia through the us e of this epidural catheter. (C) 2000 by Elsevier Science Inc.