title: Peribulbar block in patients scheduled for eye procedures and treated with clopidogrel.
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.
authors.affiliation: Département d'Anesthésie Réanimation, Rouen University Hospital, Centre Hospitalier Universitaire de Rouen, 1 rue de Germont, 76031, Rouen cedex, France. emile.calenda@chu-rouen.fr
authors.forename: Emile
authors.initials: E
authors.lastname: Calenda
authors.forename: Laure
authors.initials: L
authors.lastname: Lamothe
authors.forename: Olivier
authors.initials: O
authors.lastname: Genevois
authors.forename: Annie
authors.initials: A
authors.lastname: Cardon
authors.forename: Marc
authors.initials: M
authors.lastname: Muraine
mesh_terms: D000368:Aged; D000772:Anesthesia, Local / Q000009:adverse effects / Q000379:methods; D016022:Case-Control Studies; D000077144:Clopidogrel; D005130:Eye Hemorrhage / Q000209:etiology*; D006801:Humans; D009407:Nerve Block / Q000379:methods*; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods*; D011446:Prospective Studies; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D000077144:Clopidogrel; D013988:Ticlopidine