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

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 degrees 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.