Epidural Blood Patch

An epidural blood patch is an outpatient procedure where a small amount of your blood is used to seal leaking spinal fluid caused by an epidural, lumbar puncture, or spontaneous cerebrospinal fluid (CSF) leak.

A CSF leak decreases the pressure of the spinal fluid in the spine. This low pressure leads to a spinal headache which causes severe pain with standing or sitting but is relieved with lying flat. Injecting your blood into the epidural space at the level of the leak creates a patch. This will stop the leak of spinal fluid, restore normal pressure, and relieve your headache.

Before the Procedure
A nurse will call you to review your medicines and health history.

You will need to stop certain over the counter medicines. They include herbal supplements, vitamins, or nonsteroidal anti-inflammatory agents (NSAIDS) like ibuprofen (Advil®), or naproxen (Aleve®).

You will need to stop certain blood thinning medicines such as aspirin, Plavix®, warfarin (Coumadin®). Do not stop these medicines without talking to your doctor or our nursing staff.

There may be medicines you will need to take before the procedure for certain drug allergies, such as X-ray (contrast) dye.

You will need labs work if you are on blood thinning medicines.

Drink plenty of fluids the day before your procedure to keep hydrated.

You cannot drive yourself home. We will need rescheduled if you do not have someone to drive you home.

Day of Procedure

• Do not eat solid foods for 6 hours before your arrival time.

• You may drink clear liquids (water, apple juice, or black coffee) up to two hours before your arrival time.

• Take your routine medicines on the day of the procedure unless told not to by your doctor or our nursing staff. Take medicine with a few sips of water.

• You cannot have the procedure if you are sick. Please call
  (608) 287-2990 at least 24 hours in advance if you have:

  • An infection and/or have recently taken antibiotics

  • Cold or flu symptoms or feel sick

  • Any rashes, wounds, or skin lesions

  • A fever over 100.4° F

What to Expect
You will go to the pre-procedure area where you will change into a gown. A nurse will take your vital signs, and start two IVs. One is used to give you medicines and fluids. The other is used for drawing your blood.

A nurse will ask you about your health history, current health status, and medicines. A member of the health care team will talk to you about the procedure and its risks, and answer your questions. You will complete paperwork and sign a consent form.

Your family and friends are welcome to be with you before and after the procedure.

The blood patch is done in a procedure room that has an X-ray machine. You will lie face down on a table. Pillows will be used to help position you and keep you comfortable.

Your vital signs will be closely watched. If needed, you will receive IV medicines to help you relax. You will remain awake.

Your back will be cleaned and covered with a sterile drape. Using the X-ray machine, a thin needle will be guided to the site of the spinal fluid leak. X-ray (contrast) dye will be injected through the needle, to confirm placement.

A small amount of blood will be drawn from your arm and injected right away into your back. You will be asked to lie still and to let your doctor know if you feel any back or leg pain. The procedure takes about 30 minutes.

After the Procedure
You will return to your room for about 30 minutes. Your vital signs and pain level will be closely watched. Your doctor may have you lay flat at first, and then slowly sit up. You will be given something to drink and a light snack.

A nurse will also review discharge information. You will be given a pain log to fill out over the next two weeks.

Your driver will take you home. You may not drive for 24 hours. If you had sedation medicines, you should not make important decisions until the next day.

Activity

• Take it easy at home. Your back may feel stiff and sore for a few days.

• Avoid heavy lifting or intense physical activity for 24 hours.

• Drink plenty of fluids.

• No swimming or tub baths for 24 hours. Taking a shower is okay.
  

Signs of Infection

• Fever over 100.4° F by mouth for 2 readings taken 4 hours apart

• Increased redness, swelling around the blood patch site

• Any drainage from the site

• Severe stiff neck or problems thinking clearly
  

When to Call
The day of the procedure, if you have any problems or concerns, call Madison Surgery Center.

For new symptoms or signs of infection call your doctor listed on the After-Visit Summary.
To discuss the next steps in your plan of care, contact the provider that ordered your procedure.

Who to Call
Madison Surgery Center (6 am-5 pm)
608-287-2200

After hours if it is an emergency please visit your closest emergency room.

If it is not an emergency, please contact the ordering provider’s clinic or the provider’s clinic that performed the procedure. Tell the receptionist you had a procedure that day and need to see your doctor.