Timing of Epidural Placement After an Epidural Blood Patch

TL;DR

This paper discusses the timing of epidural catheter placement after an epidural blood patch in a cervical cancer patient undergoing brachytherapy.

Contribution

The paper presents a case highlighting the lack of guidance on optimal timing for epidural catheter placement after a blood patch.

Findings

A patient required an epidural blood patch during brachytherapy for postdural puncture headache.

There is limited literature on the optimal timing for subsequent epidural catheter placement after a blood patch.

Abstract

Epidural placement is a mainstay in the pain management of patients undergoing brachytherapy treatment of cervical cancer. A significant number of patients undergo multiple treatment cycles over the course of several weeks, necessitating repeated neuraxial catheter placements. This increases the risk of complications, including postdural puncture headaches, which may require further neuraxial instrumentation for the administration of an epidural blood patch. We present the case of a patient who received an epidural blood patch for postdural puncture headache in the middle of her brachytherapy treatment series. There is limited literature addressing the optimal timing for subsequent epidural catheter placement after an epidural blood patch.