Anesthetic management of a parturient with hyperhomocysteinemia.
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.
Luzardo
German E
GE
Department of Anesthesiology and Critical Care Medicine, University of South Florida, Tampa, FL 33606, USA.
Karlnoski
Rachel A
RA
Williams
Brooke
B
Mangar
Devanand
D
Camporesi
Enrico M
EM
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*
D018685:Anesthetics, Inhalation; D000925:Anticoagulants; D017984:Enoxaparin; D006710:Homocysteine; D006493:Heparin; D009609:Nitrous Oxide