EPIDURAL BLOOD PATCH VIA IN SITU EPIDURAL CATHETER FOR POST DURAL PUNCTURE HEADACHE

Post Dural Puncture Headache (PDPH) is a known complication of epidural procedures during labor analgesia and cesarean sections. In this study, we investigated the efficacy of managing PDPH using an Epidural Blood Patch (EBP) via an in-situ epidural catheter within 48 hours of accidental Dural puncture (ADP). Out of 1688 epidurals, 65 resulted in ADP (3.85%) with 43 cases developing PDPH (2.85% of total epidurals). Patients with ADP were managed by redirecting the needle and placing the catheter carefully, and those developing symptoms were monitored post-delivery and taken up for EBP if needed. EBP success was observed in 41 out of 43 patients, with two requiring a second patch. Additionally, two patients who initially went home symptom-free returned with PDPH after 7 days and were treated successfully with a single shot EBP. Discussion highlights PDPHs nature, conservative therapies, and the success of EBP in treating moderate to severe cases. Contradicting common practice, we performed EBP within 48 hours to avoid a second puncture, reduce hospital resources, and increase patient satisfaction. The procedure was well-tolerated, providing relief and allowing for early discharge with the baby. Injecting 10-15 ml of blood via epidural catheter effectively spreads blood at low pressure, reducing pressure symptoms and enhancing patient comfort. Careful consideration of contraindications, administration timing, and potential complications is crucial for successful EBP via in-situ catheters, offering a safe and effective treatment option for PDPH within 48 hours of ADP.