It is well accepted that post dural puncture headaches (PDPHA) are a risk of spinal anesthesia or analgesia as well as other procedures in which the dura is punctured. The problem of these potential headaches in our current practice of anesthesiology continues to be a concern. The redesign of needles to minimize the risk of headache has certainly improved the likelihood of uncomplicated spinal anesthesia. The redesign has resulted in the availability of smaller gauge needles as well as needles with different shape tips including pencil point needles. The engineering goal has been to create a puncture which disrupts the structure of the dura as little as possible and allows this minimal puncture to heal spontaneously. When prevention fails we must treat the complication. There are various conservative therapies. The use of caffeine both orally and intravenously has become more popular also with substantial success. The invasive therapy of epidural blood patches generally follows failed conservative treatment.

I had one of these today. After being layed up in bed for weeks eating pain pills like candy, I was cured in 5 minutes. God bless the blood patch. They found a good vein, tapped just outside of the spinal dura (OW!), tapped the vein for 15ccs of blood, then quickly squirted it into my back.

The pressure gave me a terrible headache for 5 minutes. Then my headaches, which were bothering me all morning and have made me unable to anything but lie around for more than two weeks, went away completely. Cured in 5 minutes.

This procedure is the bomb. Sounded crazy when I first heard of it, but it makes sense: the blood clots just outside the spinal dura, which in a spinal headache is leaking from a hole made during a spinal tap, and the hole is quickly patched.

Amen modern medicine.