2018, Number 4
Rev Mex Anest 2018; 41 (4)
Low volumes of blood patch for the definitive treatment of post-puncture headache of dura mater in Mexican obstetric patients
Ordaz-Díaz A, Chávez-Ruiz I, Ramos-Betancourt N
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ABSTRACTIntroduction: Dural puncture occurs in 0.5 to 2% of epidural blocks with an incidence of post-puncture headache of 70 to 85%. The blood patch is considered the gold standard in the treatment, currently using 15 to 20 milliliters of autologous blood. Material and methods: In a series of cases of patients with dura puncture in a private gy-necological-obstetric hospital in Mexico City, from January 2015 to December 2016, the manage-ment was reported on an excel basis. carried out, the start time after the event and the volume of autologous blood used. Results: Twenty-five patients with dura mater puncture from a total of 2,514 neuraxial anesthesia were included. The management of dura puncture was with a blood patch in 52% of cases and conservative in 48%. The mean time from dura puncture to treatment was five hours (SD 3.02, two to 12 hours) for conservative treatment and 29.5 hours (10.5, 24-48 hours) for treatment with blood patch (p ‹ 0.001, U of Mann Whitney). The average volume of autologous blood used was 8.85 mL. Discussion: We observed that it is not necessary to use volumes of 15 to 20 milliliters to achieve success in the remission of the symptomatology, low volumes of 6 to 12 milliliters became effec-tive.