Table 1 Previously reported obstetric cases with adverse events following autologous epidural blood patch
Reference | Age (years) | UDP or attempted procedure | Level of injury | AEBP | Level of AEBP | Outcomes | |
|---|---|---|---|---|---|---|---|
Aldrete, USA, 1997 [26] | 34 | LA | Multiple attempts at epidural placement | N/S | Prophylactic 19 mL from the indwelling catheter, which the author presumes to have been subdurally placed | N/S | Severe low back pain radiating toward both lower extremities, burning sensation in both feet, photophobia, and phonophobia Lumbar pain and burning sensation in the lower extremities 18 months later |
Oh, USA, 1998 [27] | 30 | CS | Difficult spinal anesthesia | L2–3 | Therapeutic 20 mL 5 days later | N/S | Fever, worsening headache, photophobia, and nuchal rigidity No neurologic sequelae 14 days later |
Kalina, USA, 2004 [10] | 27 | LA | UDP with an epidural needle | N/S | Therapeutic 27 mL 4 days later | N/S | Severe back pain and radicular symptoms Symptoms gradually improved over several months |
Riley, USA, 2009 [18] | 39 | ECV | UDP with an epidural needle | L3–4 | Therapeutic 58 mL 1 day later | L3–4 | Persistent back and right leg pain 1 week later Subdural hematoma on MRI Complete resolution of symptoms 2 weeks later |
33 | LA | Multiple attempts at epidural placement | L4–5 | Therapeutic 35 mL 1 day later 60 mL 2 days later 70 mL 4 days later | L3–4 L4–5 L2–3 | Burning pain in the posterior buttocks and left thigh without numbness or weakness Segregation of the nerve roots and thecal sac on MRI Residual symptoms despite physiotherapy 6 months later | |
Verduzco, USA, 2011 [24] | 37 | PTL | Spinal anesthesia | L3–4 | Therapeutic 20 mL 12 h later | L3–4 | Neck discomfort that progressed over 10 days to the waist and both buttocks with radiation to the lateral aspect of both thighs No neurologic sequelae 5 weeks later |
Devroe, Belgium, 2015 [17] | 27 | LA | UDP with an epidural needle Intrathecal catheter placed | N/S | Therapeutic 20 mL 4 days later | N/S | Back pain, lumbar muscle spasms radiating to both buttocks and legs, and fever No neurologic sequelae 14 days later |
Carlswald, Sweden, 2015 [19] | 29 | LA | UDP with an epidural needle Intrathecal catheter placed | L3–4 | Therapeutic 25 mL 36 h later 30 mL 2 days later | L2–3 N/S | Lumbar pain and radiculopathy in both legs as well as pain radiating to the upper thoracic region Wheelchair-bound 1 year later Arachnoiditis still demonstrable with MRI 2 years later |
Hudman, UK, 2015 [20] | 27 | LA | UDP unrecognized Procedure aborted | N/S | Therapeutic One dose 2 days later Another dose 3 days later | N/S N/S | Lower back pain that radiated to the left leg, worsening over the next 2 days No neurologic sequelae 10 days later |
Roy-Gash, France, 2017 [25] | 24 | LA | UDP with an epidural needle Intrathecal catheter placed | L3–4 | Therapeutic 30 mL 3 days later | L3–4 | Fever, shivering, stiff neck, intense lower back pain, bilateral leg pain, frontal postural headache, dizziness, and diaphoresis 7 days later No neurologic sequelae 14 days later |