A 27-year-old female para 2 (86 kg and 161 cm) had an accidental dural puncture at L3–4 spinal interspace while giving an epidural for labor pain. The next attempt at L2–3 interspace was successful, and the epidural analgesia for labor and delivery worked very well. She was discharged with her baby two days later. Three days later, she is back in the emergency room complaining of a severe post-dural puncture headache. She agrees to a blood patch.
The patient is placed in the lateral decubitus position, and the epidural space is located at L3–4 interspaces using a loss of resistance to air technique. This is followed by 3 mL of 3% 2-chloroprocaine test dose. A bilateral sensor loss at T10–12 with no motor deficit is seen within 6 minutes. Thereafter, 20 mL of autologous blood is withdrawn in a sterile manner from the patient. The blood is injected through the epidural needle, and the…
