Best time for the application of the "blood patch" technique for post-spinal anesthesia headache: a systematic review

Introduction With the puncture of the dura mater during spinal anesthesia, excessive cerebrospinal fluid (CSF) leakage can occur, leading to intracranial hypotension and, consequently, post-dural puncture headache. Currently, there are symptomatic supportive treatments, but they do not provide complete relief. The epidural blood patch has emerged as a treatment option with proven success, but there are still questions about the best timing for its use. ObjectiveTo identify the best timing for the application of the epidural blood patch. MethodSystematic review of clinical trials and randomized clinical trials on PubMed from 2000 to 2023. ResultsThe review of the articles covers various topics on the use of the blood patch, including its effectiveness, comparison with conservative treatment, volume applied, timing of application, duration of supine positioning due to pain incapacity, and needle size. However, data regarding the timing of application were not extensively highlighted. ConclusionIt was not possible to accurately determine the best timing for the application of the technique due to the lack of data, but its effectiveness is well-known, requiring further studies to better prescribe this treatment.