RT Journal Article
T1 Differential efficacy with epidural blood and fibrin patches for the treatment of post-dural puncture headache
A1 Lopez-Millan, Jose Manuel
A1 Ordoñez-Fernandez, Antonio
A1 Muriel-Fernandez, Jorge
A1 Dueñas-Diez, Jose L.
K1 Blood
K1 Dural
K1 Epidural
K1 Fibrin
K1 Headache
K1 Patch
K1 Puncture
AB BackgroundAccidental dural puncture (ADP) is the most frequent major complication when performing an epidural procedure in obstetrics. Consequently, loss of pressure in the cerebrospinal fluid (CSF) leads to the development of post-dural puncture headache (PDPH), which occurs in 16%–86% of cases. To date, the efficacy of epidural fibrin patches (EFP) has not been evaluated in a controlled clinical trial, nor in comparative studies with epidural blood patches (EBP).MethodsThe objective of the present study was to compare the efficacy of EFP with respect to EBP for the treatment of refractory accidental PDPH. This prospective, randomized, open-label, parallel, comparative study included 70 puerperal women who received an EBP or EFP (35 in each group) after failure of the conventional analgesic treatment for accidental PDPH in a hospital.ResultsA higher percentage of women with EFP than EBP achieved complete PDPH relief after 2 (97.1% vs. 54.3%) and 12 h (100.0% vs. 65.7%) of the patch injection. The percentage of patients who needed rescue analgesia was significantly lower with EFP after 2 (2.9% vs. 48.6%) and 12 h (0.0% vs. 37.1%). After 24 h, PDPH was resolved in all women who received EFP. The recurrence of PDPH was reported in one woman from the EBP group (2.9%), who subsequently required a second patch. The mean length of hospital stay was significantly lower with EFP (3.9 days) than EBP (5.9 days). Regarding satisfaction, the mean value (Likert scale) was significantly higher with EFP (4.7 vs. 3.0).ConclusionsEFP provided better outcomes than EBP for the treatment of obstetric PDPH in terms of efficacy, safety, and patient satisfaction.
PB Wiley
SN 1530-7085
YR 2023
FD 2023-11-16
LK https://hdl.handle.net/10668/23227
UL https://hdl.handle.net/10668/23227
LA en
NO López-Millán JM, Fernández AO, Fernández JM, Dueñas Díez JL. Differential efficacy with epidural blood and fibrin patches for the treatment of post-dural puncture headache. Pain Pract. 2023 Nov 16
DS RISalud
RD Apr 8, 2025