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PAIN MEDICINE

Epidural Blood Patch and Acute Varicella

Department of Anesthesiology, Division of Pain Medicine, Mayo Clinic, Rochester, Minnesota

Address correspondence and reprint requests to David P. Martin, MD, PhD, Department of Anesthesiology, Mayo Clinic, 200 First St. S.W., Rochester, MN 55905. Address e-mail to martin.david{at}mayo.edu

We present the case of a 38-yr-old woman who required an epidural blood patch in the context of acute varicella (chickenpox). The unique risks in this case include the possible triggering of central nervous system complications after the introduction of viremic blood into the epidural or intrathecal space. However, the risk was believed to be acceptable because the patient was receiving antiviral coverage. She enjoyed complete relief of her headache but experienced transient back and leg pain. Leptomeningeal irritation caused by acute varicella infection may put patients at increased risk for pain after epidural blood patch.

IMPLICATIONS: Epidural blood patch may be a safe therapeutic option for patients with postdural puncture headache in the context of acute varicella (chickenpox). In these circumstances, patients should first receive adequate antiviral coverage.

This article has been cited by other articles:

				R. T. M. van Dongen and B. M. Gerritse Epidural Blood Patch in Varicella Infection Anesth. Analg., October 1, 2005; 101(4): 1248 - 1248. [Full Text] [PDF]