[Surgical and anesthetic managements of patients with porphyria]

Although the morbidity of porphyria is rare, the surgical and anesthetic managements of patients with porphyria should be prudent, for various stresses including surgery and anesthesia may cause occurrence or exacerbation of this disease, occasionally resulting in the mortal course. Several drugs such as barbiturate, diazepam, pentazocine, and pancuronium, which can be used during anesthesia or after operation, reportedly exacerbate the disease. Furthermore, the acute exacerbation of porphyria may be misdiagnosed as acute abdomen, ileus, acute appendicitis, cholelithiasis, urolithiasis, or ectopic pregnancy. The managements of patients with acute porphyria during anesthesia and after surgery are discussed along with the introduction of our case report. Since there is no definitive treatment of porphyria, the most important thing is to understand the disease and to prevent the acute exacerbation of the disease. When patients are suspected of porphyria or possible porphyria, careful management is required during anesthesia and after operation with selecting secure drugs against the disease.