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OBSTETRIC ANESTHESIOLOGY

Anesthetic Management of a Parturient with Hyperhomocysteinemia

German E. Luzardo, MD^*, Rachel A. Karlnoski, PhD, Brooke Williams, MD^*, Devanand Mangar, MD^*, and Enrico M. Camporesi, MD^*

From the *Department of Anesthesiology and Critical Care Medicine, University of South Florida, and Florida Gulf to Bay Anesthesiology, Tampa General Hospital, Tampa, Florida.

Address correspondence and reprint requests to Rachel Karlnoski, PhD, USF Department of Anesthesiology and Critical Care Medicine, 2 Columbia Dr., G-218, Tampa, FL 33606. Address e-mail to rkarlnos{at}hsc.usf.edu.

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.