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Published on: July 31, 2016
Elective cholecystectomy performed on patient with variegate porphyria-Propofol-based total intravenous anesthesia
Adam Kuźmiński1, Michał Aporowicz1, Monika Brol2
1Department and Clinic of General, Gastroenterological and Endocrine Surgery, Wroclaw Medical University, Wrocław, Poland.
Abstract:
Porphyria is caused by disorders of enzymes that synthetize porphyrins. Both elective and emergency surgical procedures on patient suffering from porphyria may provoke acute symptoms. These patients require special anesthetic management since some of commonly used anesthetic agents may also induce acute manifestation of porphyria. We present the case of 53-year-old woman previously diagnosed with porphyria who underwent elective laparoscopic cholecystectomy. Propofol-based total intravenous anesthesia with target-controlled infusion was used. Such conduct proved to be safe regarding clinical symptoms, although biochemical markers were slightly elevated after procedure. Propofol seems to be the safest hypnotic drug to use in porphyria; however, special care should be taken is such cases.
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