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Chronic Adhesive Arachnoiditis After Repeat Epidural Blood Patch

Carlswärd, C.; Darvish, B.; Tunelli, J.; Irestedt, L.

doi: 10.1097/01.aoa.0000482649.39000.84
Case Reports
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(Int J Obstet Anesth. 2015;24:280–283)

An epidural blood patch (EBP) has variable efficacy in managing postdural puncture headache (PDPH). The authors of this case report describe a patient who developed chronic adhesive arachnoiditis (CAA), which might have resulted from a repeat EBP. The patient was a healthy, 29-year-old woman with an uncomplicated pregnancy who delivered vaginally. Upon epidural placement for labor analgesia, an accidental dural puncture occurred. The epidural catheter was placed intrathecally and effective labor analgesia was provided with intermittent doses of 0.25% bupivacaine. A total of 15 mg was administered throughout labor and delivery. She developed a severe PDPH 36 hours after the accidental dural puncture.

Department of Anesthesiology, Capio St Görans Hospital, Stockholm, Sweden

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