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Recent update on epidural blood patchRecent update on epidural blood patch

Authors
Shin, Hwa Yong
Issue Date
Jan-2022
Publisher
대한마취통증의학회
Keywords
COVID-19; Epidural blood patch; Fluoroscopy; Intracranial hypotension; Post-dural puncture headache.
Citation
Anesthesia and Pain Medicine, v.17, no.1, pp 12 - 23
Pages
12
Journal Title
Anesthesia and Pain Medicine
Volume
17
Number
1
Start Page
12
End Page
23
URI
https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/54817
DOI
10.17085/apm.21113
ISSN
1975-5171
2383-7977
Abstract
Epidural blood patch (EBP) is the injection of autologous blood into the epidural space with the intent of sealing off a dural tear and stopping the leakage of cerebrospinal fluid (CSF). EBP may cause an increase in intracranial pressure (ICP) due to the mass effect of the injected blood volume, causing CSF from the spinal compartment to enter the intracranial compartment. EBP is usually considered in the management of moderate to severe headache (HA) attributed to low CSF pressure, such as post-dural puncture HA (PDPH), CSF fistula HA, and HA attributed to spontaneous intracranial hypotension (SIH) that does not respond to conservative management. However, prophylactic administration of EBP after accidental dural puncture can hardly be substantiated at present. EBP is generally safe but may rarely be associated with serious complications. Therefore, it should be carefully planned and performed under C-arm fluoroscopic guidance. Although many studies on PDPH and SIH have been conducted until recently, only few reviews have summarized the effectiveness of EBP from the perspective of a pain physician. This article reviews the current literature on the indication, contraindication, procedural consideration, post-procedural management, outcomes, and complications of EBP and the considerations for EBP in patients with COVID-19.
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Shin, Hwa Yong
의과대학 (의학부(임상-서울))
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