Effects of ankaferd® on controlling cerebrospinal fluid leakage after dural puncture in rats

ARPACI A. H., IŞIK B., ARSLAN M., Emmez Ö. H., Erdem Ö., ALKAN M.

Anaesthesia, Pain and Intensive Care, vol.20, no.4, pp.387-392, 2016 (Scopus) identifier

  • Publication Type: Article / Article
  • Volume: 20 Issue: 4
  • Publication Date: 2016
  • Journal Name: Anaesthesia, Pain and Intensive Care
  • Journal Indexes: Scopus
  • Page Numbers: pp.387-392
  • Keywords: Ankaferd, Csf leakage, Dural puncture, Epidural blood patch
  • Gazi University Affiliated: Yes


Objective: Unintentional dural puncture with an epidural needle is common and indisputably one of the most important complications of epidural anesthesia. When no regression of the complaints are observed after conservative treatment, epidural blood patch (HBP) should be planned for the treatment of patients. However, EBP is not the optimal choise because the success rate is low and the risk of potential serious complications is high. Ankaferd Blood Stopper® (ABS), which is a medicinal plant extract, has been used as a antihemorrhagic agent against various types of bleeding. The purpose of this study is to investigate the effects of ABS administration, on fibrin formation and cerebro-spinal fluid (CSF) leakage after dural puncture in a rat model. Methodology: The study was performed at Gazi University Experimental Research Center, Ankara, Turkey between May and July 2013. Eighteen rats were grouped randomly as control (Group C, n=6), dural punctured (Group DPC, n=6) and ABS application after dural puncture at the level of L4-L5 (Group A, n=6). Methylene blue was applied to the cervical level of the rat spine, in order to observe leakage from dural puncture in Group DPC, and Group A. Medulla spinalis tissues of the rats were evaluated histopathologically. Results: CSF leakage was obtained in all rats in Group DPC (100%) that were dural punctured with spinal needle and given methylene blue. However, in the group of rats that ABS was performed before methylene blue (Group A) application, CSF leakage could be obtained in only half of the rats (50%), and in none of the rats in Group C. CSF leakage ratio in Group DPC was 100% and significantly higher than that in Group C (X2 = 5.178, p=0.002). Following Ankaferd administration, CSF leakage was identified in only 50% of rats in group A and this result was similar with achieved result in Group C (X2= 1.778, p=0.182) Conclusion: We opine that Ankaferd Blood Stopper∗ (ABS) is effective in preventing CSF leakage after post dural puncture and does not cause necrosis in rat medulla spinalis tissues.