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All Journal Jurnal Ventilator: Jurnal Riset Ilmu Kesehatan dan Keperawatan
Maulfi Natsir Asy’ari
RSUD dr. Soediran Mangun Sumarso Wonogiri
Health Professions Nursing Public Health

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Epidural Blood Patch for Severe Post-Dural Puncture Headache in a Hypertensive Patient Following Spinal Anesthesia: A Case Report Maulfi Natsir Asy’ari; Yosie Arief Sanjaya; Nafi Ilhamsyah; Alfi Sachdeva Aziz Waktar; Arsya Malika Arief
Jurnal Ventilator Vol. 4 No. 1 (2026): Jurnal Ventilator
Publisher : Stikes Kesdam IV/Diponegoro Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59680/ventilator.v4i1.2495

Abstract

Post-dural puncture headache (PDPH) is a frequent complication following neuraxial anesthesia, resulting from cerebrospinal fluid (CSF) leakage and intracranial hypotension. Although typically self-limiting, severe PDPH can significantly impair patient function and delay recovery. Epidural blood patch (EBP) is considered the gold standard treatment for refractory cases; however, optimal volume and clinical considerations in patients with comorbidities such as hypertension remain underreported. We report a 45-year-old female with a history of hypertension who developed severe PDPH following spinal anesthesia for lymphadenectomy. The procedure required multiple attempts using a 25G Quincke needle. Within hours postoperatively, the patient experienced a classic orthostatic headache accompanied by photophobia, nausea, and inability to tolerate an upright position. Conservative management failed to provide improvement after 48 hours. An epidural blood patch using 10 mL of autologous blood was subsequently performed, resulting in rapid and significant symptom relief within one hour, followed by progressive clinical recovery over the next two days. This case highlights the importance of early recognition and timely intervention in PDPH, particularly in patients with overlapping symptoms such as hypertension. Notably, a lower-volume EBP (10 mL) demonstrated effective clinical outcomes, suggesting that individualized approaches may be sufficient in selected patients. Epidural blood patch remains a safe and effective definitive treatment for refractory PDPH.
Co-Authors Alfi Sachdeva Aziz Waktar Arsya Malika Arief Nafi Ilhamsyah Yosie Arief Sanjaya