What is a Blood Patch?
It is an injection of autologous (the patient’s own) blood into the epidural space to “patch” one or more holes in the dura mater (sheath surrounding the spinal cord).
A blood patch is done to provide headache relief caused by the leaking of cerebral spinal fluid into the epidural space after a lumbar puncture. Once the blood is injected, the clotting factor of the blood closes the hole in the dura.
How long does the injection take?
The procedure takes approximately 20-30 minutes, but plan to be in the office for two to three hours. This allows for your pre-op and recovery time as well. Your driver must remain in the building during your procedure.
What is actually injected?
The injection is approximately 15-20ml of your blood. The blood is taken from your arm during the procedure and then injected into the epidural space.
Will the injection hurt?
The procedure involves inserting a needle through the skin and deeper tissue (like a tetanus shot). So, there is some discomfort involved. However, we numb the skin and deeper tissues with a local anesthetic using a very thin needle just prior to inserting the epidural needle. Also, the tissue in the midline has less nerve supply, so usually you feel strong pressure and not much pain. Some patients opt to receive IV sedation, which makes the procedure easy to tolerate.
How is the injection performed?
The procedure is done with the patient lying on their stomach under live x-ray. The patient may be monitored with EKG, blood pressure cuff, and blood oxygen monitoring device. The area to be injected is cleaned with antiseptic solution and then the injection is carried out. An additional IV will be started during the procedure to collect the blood needed for the injection.
What should I expect after the injection?
Often relief is immediate, but it can sometimes take one to two days for all symptoms to completely disappear. You may also feel sore for two to three days. This is due to the mechanical process of needle insertion as well as initial irritation from the steroid itself.
What should I do after the injection?
You will be monitored for approximately an hour after the procedure and discharge shortly after that. You should have a driver to take you home. We advise the patient to take it easy for a day or two after the procedure and you should be able to return to work in one to two days. Be sure to drink plenty of fluids and avoid strenuous activities.
Will the BLOOD PATCH help me?
Most patients who have had their “spinal headache” for more than 24 hours tend to have better relief than those whose headache has recently started.
What are the risks and side effects?
Generally speaking, this procedure is safe. However, with any procedure there are risks, side effects, and possibility of complications. The most common side effect is pain – which is temporary. Other side effects include unintentional puncture of the spinal fluid containing “sack”, bleeding, no alleviation of your headache, increased pain due to the injection, infection, and nerve damage.
Who should not have this injection?
If you are allergic to any of the medications to be injected, if you are on a blood thinning medication (ex: Coumadin, Plavix), if you have an active infection going on, you should not have the injection.