Postdural puncture headache in a parturient with sickle cell disease: Use of an epidural colloid patch

Abstract

Purpose: To report the injection of a colloid in the epidural space as an alternative to an epidural blood patch in a woman with sickle cell disease. Clinical features: A Cesarean delivery was performed under spinal anesthesia in a 32-yr-old woman with severe sickle cell disease and a past medical history of vaso-occlusive crisis. In the postoperative period, the patient complained of postdural puncture headache resistant to symptomatic treatment. Because there were no data concerning the safety of a blood patch in this condition, a colloid (a modified fluid gelatin heated to 37°C) was injected in the epidural space instead of blood. Headaches decreased immediately after the epidural injection of the colloid and disappeared totally within 12 hr. Conclusion: Data concerning the safety of epidural blood patches in patients with sickle cell disease are lacking. Injection of colloids in the epidural space could be an alternative.