2026 SOAP Annual Meeting

Background:

PDPH and Epidural Blood Patch (EBP)

•Approximately 1.5% after labor epidural analgesia

•Two primary approaches to EBP:

•Conventional (landmark-based)

•Fluoroscopy-guided

•Limited data comparing techniques in OB patients

Study Objective:
Compare effectiveness of conventional vs fluoroscopy-guided EBP

Study Design:

Retrospective Cohort Study

Postpartum patients diagnosed with PDPH who received an EBP between 2018–2025

Categorized based on initial EBP technique

Primary Aim: Compare the incidence of repeat EBP

Secondary Aim: Rate of continued PDPH following EBP, Duration of time to treatment, Volume of blood injected

Results: reference figure

Discussion and Conclusion:

- No significant difference in outcomes between conventional and fluoroscopy-guided EBP

- Outcomes appear more strongly influenced by needle size for dural punctureand timing of EBP

- A randomized controlled trial is needed to further evaluate clinical utility of fluoroscopy for EBP

Fluoroscopic versus Conventional Epidural Blood Patch for Post-Dural Puncture Headache in Obstetrics: A Retrospective Cohort Study of Efficacy