Association Between Injected Volume and Epidural Blood Patch Success on Obstetric Post-Dural-Puncture Headache: A Retrospective Cohort Study
Main finding · Repeat EBP (failure of first EBP)Result — go to the resultOdds ratio 0.96 95% CI 0.92–0.999Authors' conclusion
We found that a larger injected volume of blood during an EBP was associated with a reduced likelihood of receiving a second EBP. Injection of 30 mL or more was significantly associated with complete resolution of headache symptoms after the first EBP.
Study context
- Population
- Obstetric patients receiving epidural blood patch (EBP) for post-dural-puncture headache (PDPH) after an obstetric epidural procedure, May 2014-February 202432 single-shot spinal excluded
- Participants
- 317 patients
- Exposure
- Injected blood volume during EBP
- Outcome
- Failure of the first EBP (patient receiving a second EBP)
Methodological detailssingle-centre, tertiary academic medical center
- Single-centre
- Tertiary academic medical center
Main finding
Repeat EBP (failure of first EBP)
Odds ratio
0.96
95% CI 0.92–0.999
P = 0.028
Injected volume (per 1 mL)
OR 0.96 (95% CI 0.92–0.999); P = 0.028
Per 1 mL, as printed
As reported in the abstract
- Repeat EBP performed, n (%)
- 65 (22.8%, 95% CI, 18.1%-28.1%)
- Injected volume, median (IQR), mL
- 28.0 (22.0-32.0)
- Dose-response relationship between injected volume and repeated EBP
- P = 0.030
Observational data: associations, not effects.
Secondary outcomes
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Days from PDPH diagnosis to EBP (per day), successful EBPMultivariable | 0.61 (0.43–0.81) | P = 0.002 | |
| Complete headache resolution after first EBP · follow-up ≥3 daysMultivariable | 1.85 (1.01–3.47) | P = 0.049 | |
| 0.20.5125Odds ratio (log scale) |
- Complete headache resolution after first EBP — Headache completely resolved, n (%) of 226 with follow-up
- 118 (52.2%, 95% CI, 45.5%-58.9%)
Original publication
Association Between Injected Volume and Epidural Blood Patch Success on Obstetric Post-Dural-Puncture Headache: A Retrospective Cohort Study. Anesth Analg. Published 10 February 2026. doi:10.
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