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Asian Institute of Research, Journal Publication, Journal Academics, Education Journal, Asian Institute
Asian Institute of Research, Journal Publication, Journal Academics, Education Journal, Asian Institute

Journal of Health and Medical Sciences

ISSN 2622-7258

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open access

Published: 05 February 2020

The Optimal Volume of Epidural Blood Patch in Treating Post-Dural Puncture Headache: a Mini-Review

Wan-Ting Chia, Chung-Ren Lin

National Cheng Kung University, Taiwan

journal of social and political sciences
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Pages: 64-67

Keywords: Epidural Blood Patch, Headache, Intracranial Hypotension, Cerebrospinal Fluid


Post-dural puncture headache is the major morbidity after intentional or unintentional dural puncture procedure, with CSF leakage and subsequent decrease intracranial pressure. An autologous epidural blood patch remains the most effective treatment and the option after failure of conservative treatment. The optimal blood volume of the epidural blood patch remains indeterminate, range from 5 to 30 mL. This mini-review aimed to review current evidence and literature of the blood volume injected into epidural space with the highest success rate, low repeated epidural blood patch procedure, and low complication rate.


  1. Bendel, M. A., Moeschler, S. M., Qu, W., Hanley, E., Neuman, S. A., Eldrige, J. S., & Hoelzer, B. C. (2016). Treatment of Refractory Postdural Puncture Headache after Intrathecal Drug Delivery System Implantation with Epidural Blood Patch Procedures: A 20-Year Experience. Pain Res Treat, 2016, 2134959. doi: 10.1155/2016/2134959
  2. Boonmak, P., & Boonmak, S. (2010). Epidural blood patching for preventing and treating post-dural puncture headache. Cochrane Database Syst Rev(1), Cd001791. doi: 10.1002/14651858.CD001791.pub2
  3. Booth, J. L., Pan, P. H., Thomas, J. A., Harris, L. C., & D'Angelo, R. (2017). A retrospective review of an epidural blood patch database: the incidence of epidural blood patch associated with obstetric neuraxial anesthetic techniques and the effect of blood volume on efficacy. Int J Obstet Anesth, 29, 10-17. doi: 10.1016/j.ijoa.2016.05.007
  4. Candido, K. D., & Stevens, R. A. (2003). Post-dural puncture headache: pathophysiology, prevention and treatment. Best Pract Res Clin Anaesthesiol, 17(3), 451-469.
  5. Chen, L. K., Huang, C. H., Jean, W. H., Lu, C. W., Lin, C. J., Sun, W. Z., & Wang, M. H. (2007). Effective epidural blood patch volumes for postdural puncture headache in Taiwanese women. J Formos Med Assoc, 106(2), 134-140. doi: 10.1016/s0929-6646(09)60229-1
  6. Crawford, J. S. (1980). Experiences with epidural blood patch. Anaesthesia, 35(5), 513-515. doi: 10.1111/j.1365-2044.1980.tb03834.x
  7. Harrington, B. E., & Schmitt, A. M. (2009). Meningeal (postdural) puncture headache, unintentional dural puncture, and the epidural blood patch: a national survey of United States practice. Reg Anesth Pain Med, 34(5), 430-437. doi: 10.1097/AAP.0b013e3181b493e9
  8. Kwak, K. H. (2017). Postdural puncture headache. Korean J Anesthesiol, 70(2), 136-143. doi: 10.4097/kjae.2017.70.2.136
  9. Martinez, B., Canser, E., Alonso, A., Alonso, E., Gredilla, E., Diez, J., & Gilsanz, F. (2018). Postdural Puncture Headache and Epidural Blood Patch in a Large Obstetric Anaesthesia Population. Asian J Anesthesiol, 56(1), 23-32. doi: 10.6859/aja.201803_56(1).0003
  10. Paech, M. J., Doherty, D. A., Christmas, T., & Wong, C. A. (2011). The volume of blood for epidural blood patch in obstetrics: a randomized, blinded clinical trial. Anesth Analg, 113(1), 126-133. doi: 10.1213/ANE.0b013e318218204d
  11. Szeinfeld, M., Ihmeidan, I. H., Moser, M. M., Machado, R., Klose, K. J., & Serafini, A. N. (1986). Epidural blood patch: evaluation of the volume and spread of blood injected into the epidural space. Anesthesiology, 64(6), 820-822. doi: 10.1097/00000542-198606000-00028
  12. Taivainen, T., Pitkanen, M., Tuominen, M., & Rosenberg, P. H. (1993). Efficacy of epidural blood patch for postdural puncture headache. Acta Anaesthesiol Scand, 37(7), 702-705. doi: 10.1111/j.1399-6576.1993.tb03793.x
  13. Thew, M., & Paech, M. J. (2008). Management of postdural puncture headache in the obstetric patient. Curr Opin Anaesthesiol, 21(3), 288-292. doi: 10.1097/ACO.0b013e3282f8e21a
  14. Tubben, R. E., Jain, S., & Murphy, P. B. (2019). Epidural Blood Patch StatPearls. Treasure Island (FL): StatPearls Publishing
  15. StatPearls Publishing LLC.
  16. Turnbull, D. K., & Shepherd, D. B. (2003). Post-dural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth, 91(5), 718-729. doi: 10.1093/bja/aeg231
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