Complications after Spinal or Epidural Anaesthetic - Headache - Treatment

Authored by Dr Colin Tidy, 22 May 2017

Reviewed by:
Dr Jennifer Hares, 22 May 2017

Initial treatment

  • Lying flat as much as you can will help to relieve the headache.
  • You should take a simple pain-relieving medicine, such as paracetamol. You can take ibuprofen as well.
  • Drink plenty of fluid. Caffeine drinks such as tea, coffee or cola are especially helpful. You should avoid heavy lifting and straining.

Although the hole in the dura will usually seal over in a number of weeks, it is not usually advisable to wait for this to happen.

The brain is cushioned by the CSF around it. If the headache is left untreated, this cushioning is not present and it is occasionally possible for bleeding to occur into or around the brain (a subdural haematoma). Very occasionally, a fit (seizure) can happen.

A post-dural puncture headache is often treated with an epidural blood patch.

What is an epidural blood patch?

Some of your own blood is injected into your back. The aim is that the blood seals the hole in the dura and stops the leak of fluid. Great care is taken to clean your arm and take blood in a fully clean (sterile) manner. This reduces the risk of infection. Blood is carefully injected into your back by using an epidural needle, placed near to the hole in the dura.

The blood will clot and so seal the hole that has been made in the dura. As the fluid leak is stopped, the pressure around the brain will increase and the headache should improve.

In about 2 in every 3 people who have this kind of headache, the blood patch will cure the headache within 24 hours. If the headache continues, or if the headache returns, you may be advised to have another blood patch.

What risks are associated with a blood patch?

  • A blood patch may cause local bruising on the back where the injection has been done.
  • A blood patch can occasionally cause backache and stiffness which can last a few days. Epidurals and blood patches do not cause long-term backache.
  • There is a small chance that another accidental dural puncture could occur when the blood patch injection is done.
  • Nerve damage, infection or bleeding into the back are very rare complications of epidurals, spinals and blood patches.
Get immediate medical help if any of the following occur after you have a blood patch:

  • Difficulty passing urine.
  • Severe back pain.
  • Loss of sensation in your back or legs.

Further reading and references

Has anyone suffered numbness and ongoing discomfort and pain following thoracic surgery? Its nearly 3 years since mine and I'm numb on the left side of my thorax, I get constant twisting and pulling...

paulsmith523
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