These authors contributed equally to this work.
Epidural blood patches are effective for postdural puncture headache in pediatrics – a 10-year experience
Article first published online: 27 SEP 2012
© 2012 Blackwell Publishing Ltd
Volume 22, Issue 12, pages 1205–1210, December 2012
How to Cite
Kokki, M., Sjövall, S., Kokki, H. (2012), Epidural blood patches are effective for postdural puncture headache in pediatrics – a 10-year experience. Pediatric Anesthesia, 22: 1205–1210. doi: 10.1111/pan.12034
- Issue published online: 7 NOV 2012
- Article first published online: 27 SEP 2012
- Manuscript Accepted: 5 JUL 2012
- epidural blood patch;
- postdural puncture headache;
Postdural puncture headache (PDPH) is a relatively common complication after lumbar punctures (LP). If conservative treatment is not sufficient within a few days and the symptoms are severe, an epidural blood patch (EBP) may be performed.
A chart review to evaluate the need and effectiveness of EBPs in children and adolescents over a 10-year period at Kuopio University Hospital (KUH) and Satakunta Central Hospital (SCH).
The information system patient measures databases were reviewed to identify patients who had received an EBP. Then, the pediatric patients' medical records were compared to the characteristics of the PDPH and associated symptoms and were evaluated for the effectiveness of EBPs.
Forty-two EBPs were performed in 41 patients (24 girls, 17 boys), 26 at KUH and 15 at SCH. Five patients, all at KUH, were children aged 3–12 years, and 36 patients were adolescents, aged 13–18 years. The indications for LPs were diagnostic (n = 26), spinal anesthesia/analgesia (n = 11), or introduction of chemotherapy (n = 2), and four patients developed PDPH after an inadvertent dural puncture with an epidural needle. The first EBP provided a complete relief of symptoms in 37 children, an initial success rate of 90%, and permanent relief in 85%. At KUH, the need for EBPs after spinal anesthesia/analgesia was <1/1000 in children and 2–3/1000 in adolescents, and that after chemotherapy 1–2/1000. No serious adverse effects related to EBPs were recorded.
If PDPH symptoms are severe and are not relieved with conservative treatment, EBP is a highly effective procedure in pediatric patients.