The
epidural blood patch (EBP) is a
solution for persistent
headaches following an accidental dural
puncture. We report three cases where EBP was performed immediately after dural
puncture combined with
drug administration for
lumbago. To the best of our knowledge, no similar cases have been reported in the literature. The patients provided their informed consent, and all standard protocols were followed. At the moment of the dural
puncture, all the patients manifested severe
headaches,
nausea,
vomiting, and profuse sweating. A second epidural
puncture was performed at a higher intervertebral space, followed by
drug administration and 20 mL of autologous blood. All the patients improved gradually, while their
headaches vanished after 30-35 minutes. The patients were kept in for monitoring and released the following day with specific instructions and daily phone contact for a week without any complications. Their
lumbago symptoms regressed. The possibility of
pneumocephalus was excluded because of the patients' symptomatology. The risk of high or total
spinal anesthesia due to
local anesthetic leakage subarachnoidally was countered with close monitoring of the patients. EBP complications include failure,
postdural-puncture headache worsening by an accidental additional dural tear(s),
back pain, and
infection. All patients were instructed to report any symptoms immediately. EBP executed immediately after dural
puncture seems to relieve
headache fast and does not appear to impede
epidural analgesia.