Anesthesia for cesarean section in a patient with placenta previa and methylenetetrahydrofolate reductase deficiency

Gerges, Frederic J.; Dalal, Aparna; Robelen, Gary; Cooper, Bronwyn; Bayer, Lucy

doi:10.1016/j.jclinane.2006.01.006

Cited by 6 publications

(3 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An acute increase in plasma homocysteine is associated with impaired endothelial function. It produces direct cytotoxic effects on endothelial cells and causes procoagulant activity, which includes increased platelet adhesiveness, factor V activation, protein C inhibition and antithrombin and plasminogen activator binding (5).…”

Section: Discussionmentioning

confidence: 99%

Chemotherapy Related Angioedema

Karaören¹,

Tomruk²,

Kuseyrioğlu³

et al. 2015

Turk J Anaesth Reanim

View full text Add to dashboard Cite

Objective: Methylene tetrahydrofolate reductase (MTHFR) deficiency is an autosomal recessive disorder that results in increased homocysteine levels in the body. Hyperhomocysteinemia causes a predisposition to venous and arterial thrombosis and ischaemic insults. The incidence of the deficiency is around 40% in some countries. In this study, we aimed to evaluate the effects of anaesthetic agents in children with MTHFR deficiency. Methods:Twelve paediatric patients with an MTHFR enzyme deficiency who underwent surgery in a ten-month period in a single centre were retrospectively evaluated. Demographic data, homocysteine levels before and after surgery, anaesthesia management and postoperative complications were recorded. Results:In four patients, propofol was used both for anaesthesia induction and total intravenous anaesthesia (TIVA). Eight patients received sevoflurane for both induction and maintenance of anaesthesia. Nitrous oxide (N 2 O) was not used in any patients.There was not a significant difference between the preoperative and postoperative homocysteine levels (p>0.05). Twenty-four hours after the surgery, the homocysteine levels were within normal limits. No complications were observed. Conclusion:Sevoflurane and propofol have no deleterious effects on homocysteine levels in patients with MTHFR deficiency. Avoidance of N 2 O is the key point for anaesthetic consideration regarding these patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Chemotherapy Related Angioedema

Karaören¹,

Tomruk²,

Kuseyrioğlu³

et al. 2015

Turk J Anaesth Reanim

View full text Add to dashboard Cite

show abstract

“…Intraoperatively, nitrous oxide (N 2 O) should not be used, specifi cally in patients who are homozygous for the MTHFR C677T mutation [12,13]. N 2 O inhibits methionine synthetase, resulting in the reduction of the conversion of homocysteine to methionine, thus increasing systemic homocysteine levels [14].…”

Section: Discussionmentioning

confidence: 99%

General anesthesia and methylenetetrahydrofolate reductase deficiency

2007

View full text Add to dashboard Cite

Methylenetetrahydrofolate reductase (MTHFR) deficiency is an autosomal recessive disorder with a spectrum of manifestations including neurological symptoms, premature arteriosclerosis, and venous and arterial thrombosis. Most patients are heterozygous for multiple MTHFR substitutions; small minorities are homozygous for mutations at this locus. Among these mutations, the C677T polymorphism is the most deleterious. Nitrous oxide use in anesthesia leads to significant increases in plasma homocysteine. We present a patient undergoing urgent surgery with a preoperative diagnosis of homozygous MTHFR deficiency.

show abstract

“…According to our literature research anesthesia management of the disorder is rarely reported among adults compared to pediatric cases To our knowledge, this is the first cardiac surgical case report in the literature. We found three adult case reports: one for elective colon surgery, the second for cesarean section, and the last one for urgent toe amputation (3)(4)(5). All three cases experienced occlusive events prior to surgery that led to the diagnosis of MTHFR deficiency.…”

mentioning

confidence: 99%

RE: Methylenetetrahydrofolate Reductase Deficiency: Rare but Considerable

Orhon

2018

Turk J Anaesth Reanim

View full text Add to dashboard Cite

Anesthesia for cesarean section in a patient with placenta previa and methylenetetrahydrofolate reductase deficiency

Cited by 6 publications

References 48 publications

Chemotherapy Related Angioedema

Chemotherapy Related Angioedema

General anesthesia and methylenetetrahydrofolate reductase deficiency

RE: Methylenetetrahydrofolate Reductase Deficiency: Rare but Considerable

Contact Info

Product

Resources

About