Département d'Anesthésie Réanimation, Rouen University Hospital, Centre Hospitalier Universitaire de Rouen, 1 rue de Germont, 76031, Rouen cedex, France.
J Anesth. 2012 Oct;26(5):779-82. doi: 10.1007/s00540-012-1406-6. Epub 2012 May 12.
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.
我们的假设是，与未接受氯吡格雷治疗的患者相比，当需要球周麻醉时，继续使用氯吡格雷并不会增加眼出血的风险。我们前瞻性的病例对照研究纳入了两组各 1000 名计划接受需要球周阻滞的眼内手术的患者。接受氯吡格雷治疗的患者被纳入 A 组（1000 例）。从未接受过氯吡格雷治疗的患者构成对照组（B 组，1000 例）。出血分级如下：1=眼睑瘀斑和/或球结膜下出血；2=眼睑瘀斑累及眼睑表面积的一半；3=眼睑瘀斑环绕整个眼睛，眼压无升高；4=眼后出血伴眼压升高。A 组中有 30 例（3.0%）患者出现 1 级出血，B 组中有 20 例（2.0%）患者出现 1 级出血。未发生 2 级、3 级或 4 级出血。两组间出血分级无显著差异（p=0.017）。氯吡格雷与潜在视力威胁的局部麻醉并发症的显著增加无关。
