Anesthesia and the porphyrias

The porphyrias are a result of disordered heme metabolism. The sequelae are related to the accumulation of precursors and/or their metabolism. Induced drug metabolism can lead to acute attacks and may result in fatalities. Careful selection of intravenous agents, absolute avoidance of barbiturates, and use of inhalation agents can enable the anesthetist to administer safe anesthesia to these endangered patients.