Up until recently, doctors had no idea if people who needed eye surgery but were on blood thinners could continue taking their medication safely prior to their procedure. Many patients receive a nerve block on their eye and it was unclear if patients needed to stop taking them before receiving the nerve block.
But thanks to a new study led by anesthesiologists at Hartford Hospital’s Eye Surgery Center, patients should feel reassured that they can safely continue their medications when receiving eye nerve blocks for eye procedures. The study, called the Blocking Eyes with Quality and Safety (BEQUEST) Initiative, examines procedures like cataract and glaucoma surgery, and some cornea procedures
“A lot of our patients are taking blood thinners for serious medical conditions,” said Kevin Finkel, MD, an anesthesiologist at the Hartford Hospital Eye Surgery Center.
These medications are helpful in preventing heart attacks and strokes, but there hasn’t been much research on the safety of the newer blood thinners and the nerve blocks used in some eye surgeries. This includes medications such as Eliquis (apixaban), Xarelto (rivaroxaban), and Pradaxa (dabigatran etexilate).
“About 40 percent of our patients receive a nerve block anesthetic during their eye surgery, with over 50 percent taking some sort of blood thinner. Based on the findings from our study, we don’t want patients to have to stop taking these important medications simply because they are receiving a block. We want to do the safest thing for our patients,” said Dr. Finkel.
In 2014, Dr. Finkel began collecting data on bleeding complications and the quality of the nerve blocks offered at the Center. Since that time, doctors have collected data on over 11,000 patients.
The data shows that nerve blocks are incredibly safe and done with high-quality. In fact, 90 percent have been deemed “perfect” blocks. This means that there is no movement and no sensation at all felt by the patients in the eye.
The most serious, but rare complication with a nerve block is a retrobulbar hematoma, which is bleeding behind the eye. The typical incidence of this complication nationally is around 1 to 3 percent. In this study, the incidence was 0.018%, nearly 100 times less than the national average.
“The anesthesiologists and surgeons at the Hartford Hospital Eye Surgery Center perform a high volume of nerve blocks, averaging over 1,000 each during the four years of the study,” said Dr. Finkel.
Results from the study were presented at the 44th National Meeting of the American Society of Regional Anesthesia in Las Vegas in April 2019.
Doctors at Hartford Hospital’s Eye Surgery Center perform approximately 3,000 nerve blocks every year. For more information on the Eye Surgery Center, visit www.eyesurgerycenter.org.