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Epidural Blood Patch in Varicella Infection

Martin, David P., MD, PhD

doi: 10.1213/01.ANE.0000173766.32176.D4
Letters to the Editor: Letters & Announcements

Anesthesiology and Pain Medicine; Mayo Clinic; Rochester, MN;

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In Response:

We appreciate Drs. van Dongen and Gerritse’s thoughtful comments. Indeed, we have used fibrin glue to treat persistent cerebrospinal fluid leaks. However, we believe they are mistaken in their assertion that fibrin glue is derived by a recombinant DNA process. To our knowledge, all commercially available fibrin glue products are prepared from pooled human plasma. Although the product is vapor heated and tested, there remains a small risk of viral infection. Moreover, because the fibrinolysis inhibitor is bovine in origin, there is a risk of allergic reaction when using these products. Therefore, it is our practice to consider fibrin glue only after failure of one or more blood patches.

David P. Martin, MD, PhD

Anesthesiology and Pain Medicine

Mayo Clinic

Rochester, MN

© 2005 International Anesthesia Research Society