Epidural blood patches are effective for postdural puncture headache in pediatrics – a 10‐year experience

Summary Background Postdural puncture headache ( PDPH ) is a relatively common complication after lumbar punctures ( LP ). If conservative treatment is not sufficient within a few days and the symptoms are severe, an epidural blood patch ( EBP ) may be performed. Aim A chart review to evaluate the need and effectiveness of EBP s in children and adolescents over a 10‐year period at K uopio U niversity H ospital ( KUH ) and S atakunta C entral H ospital ( SCH ). Methods The information system patient measures databases were reviewed to identify patients who had received an EBP . Then, the pediatric patients' medical records were compared to the characteristics of the PDPH and associated symptoms and were evaluated for the effectiveness of EBP s. Results Forty‐two EBP s were performed in 41 patients (24 girls, 17 boys), 26 at KUH and 15 at SCH . Five patients, all at KUH , were children aged 3–12 years, and 36 patients were adolescents, aged 13–18 years. The indications for LP s were diagnostic ( n  = 26), spinal anesthesia/analgesia ( n  = 11), or introduction of chemotherapy ( n  = 2), and four patients developed PDPH after an inadvertent dural puncture with an epidural needle. The first EBP provided a complete relief of symptoms in 37 children, an initial success rate of 90%, and permanent relief in 85%. At KUH , the need for EBP s after spinal anesthesia/analgesia was <1/1000 in children and 2–3/1000 in adolescents, and that after chemotherapy 1–2/1000. No serious adverse effects related to EBP s were recorded. Conclusion If PDPH symptoms are severe and are not relieved with conservative treatment, EBP is a highly effective procedure in pediatric patients.