Peribulbar block in patients scheduled for eye procedures and treated with clopidogrel

J Anesth. 2012 Oct;26(5):779-82. doi: 10.1007/s00540-012-1406-6. Epub 2012 May 12.

Abstract

Our hypothesis was that the continuation of clopidogrel does not increase the risk of eye hemorrhage, compared to patients not treated with clopidogrel, when a peribulbar anesthesia is required. Our prospective case-control study enrolled two groups of 1,000 patients scheduled for intraocular eye surgery requiring a peribulbar block. Patients treated with clopidogrel were included in group A (1,000 patients). Patients who had never been treated with clopidogrel constituted the control group (group B, 1,000 patients). Hemorrhages were graded as follows: 1 = spot ecchymosis of eyelid and or subconjunctival hemorrhage; 2 = eyelid ecchymosis involving half the lid surface area; 3 = eyelid ecchymosis all around the eye, no increase in intraocular pressure; 4 = retrobulbar hemorrhage with increased intraocular pressure. Grade 1 hemorrhages were observed in 30 patients (3.0 %) in group A and in 20 patients (2.0 %) in group B. No grade 2, 3, or 4 hemorrhage was encountered. There was no significant difference in the grading of hemorrhage between the groups (p = 0.017). Clopidogrel was not associated with a significant increase in potentially sight-threatening local anesthetic complications.

MeSH terms

  • Aged
  • Anesthesia, Local / adverse effects
  • Anesthesia, Local / methods
  • Case-Control Studies
  • Clopidogrel
  • Eye Hemorrhage / etiology*
  • Humans
  • Nerve Block / methods*
  • Ophthalmologic Surgical Procedures / adverse effects*
  • Ophthalmologic Surgical Procedures / methods*
  • Prospective Studies
  • Ticlopidine / administration & dosage
  • Ticlopidine / adverse effects
  • Ticlopidine / analogs & derivatives*

Substances

  • Clopidogrel
  • Ticlopidine