PROPOFOL AS AN I.V. ANAESTHETIC INDUCTION AGENT IN VARIEGATE PORPHYRIA

The choice of an i.v. anaesthetic induction poses problems for the anaesthetist confronted with a patient with one of the acute porphyrias. We undertook a prospective clinical trial in 13 variegate porphyric subjects using propofol as an anaesthetic induction agent. Urinary porphyrin precursors and...

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Bibliographic Details
Published in:British journal of anaesthesia : BJA 1991-01, Vol.66 (1), p.60-65
Main Authors: MEISSNER, P.N., HARRISON, G.G., HIFT, R.J.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Anaesthetics
Anesthesia, Intravenous
Anesthetics. Neuromuscular blocking agents
Biological and medical sciences
Complications: porphyria
Humans
intravenous: propofol
Liver Diseases - complications
Liver Diseases - metabolism
Medical sciences
Middle Aged
Neuropharmacology
Pharmacology. Drug treatments
Porphyrias - complications
Porphyrias - metabolism
Porphyrins - metabolism
Propofol
Prospective Studies
Skin Diseases - complications
Skin Diseases - metabolism
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Summary:The choice of an i.v. anaesthetic induction poses problems for the anaesthetist confronted with a patient with one of the acute porphyrias. We undertook a prospective clinical trial in 13 variegate porphyric subjects using propofol as an anaesthetic induction agent. Urinary porphyrin precursors and porphyrins were measured before operation and 1–5 days after operation. Stool and plasma porphyrin concentrations were measured over the same period. Comparison of these data in the porphyric patients and in 21 control subjects over the trial period revealed no significant change in porphyrin or porphyrin precursor output after operation. Urinary porphyrin precursor concentrations did not exceed the limits established for variegate porphyric patients in remission, and there were no changes in the stool and plasma porphyrin profiles or any symptoms of an acute porphyric attack. We conclude that propofol did not appear to be porphyrinogenic when used for the induction of anaesthesia in 13 patients with variegate porphyria.
ISSN:0007-0912
1471-6771
DOI:10.1093/bja/66.1.60