Postoperative bleeding risk for oral surgery under continued clopidogrel antiplatelet therapy

Biomed Res Int. 2015:2015:823651. doi: 10.1155/2015/823651. Epub 2015 Jan 6.

Abstract

Object: To determine the incidence of postoperative bleeding for oral osteotomy carried out under continued monoantiplatelet therapy with clopidogrel and dual therapy with clopidogrel/aspirin. Design. Retrospective single center observatory study of two study groups and a control group.

Methods: A total of 64 and 60 oral osteotomy procedures carried out under continued monoclopidogrel therapy and dual clopidogrel/aspirin therapy, respectively, were followed for two weeks for postoperative bleeding. Another 281 similar procedures were also followed as a control group. All oral osteotomy procedures were carried out on an outpatient basis.

Results: We observed postoperative bleeding in 2/281 (0.7%) cases in the control group, in 1/64 (1.6%) cases in the clopidogrel group, and in 2/60 (3.3%) cases in the dual clopidogrel/aspirin group. The corresponding 95% confidence intervals are 0-1.7%, 0-4.7%, and 0-7.8%, respectively, and the incidences did not differ significantly among the three groups (P > 0.09). Postoperative hemorrhage was treated successfully in all cases with local measures. No changes of antiplatelet medication, transfusion, nor hospitalisation were necessary. No major cardiovascular events were recorded.

Conclusions: Our results indicate that minor oral surgery can be performed safely under continued monoantiplatelet medication with clopidogrel or dual antiplatelet medication with clopidogrel/aspirin.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Case-Control Studies
  • Clopidogrel
  • Female
  • Humans
  • Male
  • Middle Aged
  • Oral Surgical Procedures / adverse effects*
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Postoperative Hemorrhage / drug therapy*
  • Postoperative Hemorrhage / etiology*
  • Risk Factors
  • Ticlopidine / analogs & derivatives*
  • Ticlopidine / therapeutic use

Substances

  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Ticlopidine