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.