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Anesth Analg 2004;99:1760-1762
© 2004 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000136473.18712.4B

PAIN MEDICINE

Epidural Blood Patch and Acute Varicella

David P. Martin, MD, PhD, Bradley D. Bergman, DO, and Ines H. Berger, MD

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.




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R. T. M. van Dongen and B. M. Gerritse
Epidural Blood Patch in Varicella Infection
Anesth. Analg., October 1, 2005; 101(4): 1248 - 1248.
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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2004 by the International Anesthesia Research Society.