title: Anesthetic management of a parturient with hyperhomocysteinemia.
abstract: High plasma levels of homocysteine are associated with an increased risk for thromboembolic events. Neuraxial anesthesia techniques may be relatively contraindicated in anticoagulated patients, and nitrous oxide may exacerbate the condition by inhibiting the conversion of homocysteine to methionine. We describe the anesthetic implications and management of a patient with hyperhomocysteinemia undergoing an nonemergent cesarean delivery.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, University of South Florida, Tampa, FL 33606, USA.
authors.forename: German E
authors.initials: GE
authors.lastname: Luzardo
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Karlnoski
authors.forename: Brooke
authors.initials: B
authors.lastname: Williams
authors.forename: Devanand
authors.initials: D
authors.lastname: Mangar
authors.forename: Enrico M
authors.initials: EM
authors.lastname: Camporesi
mesh_terms: D000328:Adult; D000775:Anesthesia, Spinal; D018685:Anesthetics, Inhalation / Q000009:adverse effects; D000925:Anticoagulants / Q000008:administration & dosage*; D001777:Blood Coagulation / Q000187:drug effects*; D001780:Blood Coagulation Tests; D016063:Blood Loss, Surgical; D002585:Cesarean Section; D004334:Drug Administration Schedule; D017984:Enoxaparin / Q000008:administration & dosage; D005260:Female; D006493:Heparin / Q000008:administration & dosage; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000188:drug therapy*; D050498:Live Birth; D009609:Nitrous Oxide / Q000009:adverse effects; D036801:Parturition / Q000097:blood*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000188:drug therapy*
chemical_list: D018685:Anesthetics, Inhalation; D000925:Anticoagulants; D017984:Enoxaparin; D006710:Homocysteine; D006493:Heparin; D009609:Nitrous Oxide