AFTER AN EPIDURAL BLOOD PATCH
After being treated for a spinal CSF leak, there are steps that can be taken to enhance the prospect of being sealed.
THE FIRST 72 HOURS AND BEYOND
It is recommended to remain flat for 72 hours following the epidural blood patch. Upright only for bathroom breaks.
No bending, twisting, or reaching. No lifting more than about 10 pounds.
If you develop Rebound Intracranial Hypertension, reverse the pattern and remain upright in a reclining chair.
NO B.L.T. FOR UP TO 6 MONTHS
Activities can be resumed, however with some limitations to allow the patch to get stronger. NO Bending - NO Lifting (not more than about 10 pounds) - NO Twisting.
Spinal CSF leaks are treatable. Once a leak has been successfully sealed, patients can be optimistic about the prognosis. Many times, successful outcome will be measured in months rather than days.
Discuss the recovery room protocol with the attending physician prior to treatment. Ideally, patients remain flat for at least two (2) hours following the epidural patch to allow the blood to travel along the spine.
Cold packs may be helpful for back soreness which peaks approximately 3 days after the epidural blood patch and then gradually diminishes.
It is important to manage post-patch vomiting (if it is present). Discuss taking anti-nausea medication with the physician. Vomiting can generate harmful pressure that may open up the leak. Accordingly, managing vomiting will assist in preventing patch failure.
It is important to manage post-patch constipation. Discuss taking an over-the-counter stool softener with the physician. Constipation and related over-exertion may lead to patch failure.
Sources & Suggested Reading
Kranz PG, Amrhein TJ, Gray L. Rebound intracranial hypertension: a complication of epidural blood patching for intracranial hypotension. AJNR Am J Neuroradiol. 2014;35(6):1237-1240. Google ScholarCrossrefPubMed.