British Journal of Anaesthesia, 1985, Vol. 57, No. 4 420-423
© 1985 The Board of Management and Trustees of the British Journal of Anaesthesia
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PORPHYRINOGENICITY OF ETOMIDATE AND KETAMINE AS CONTINUOUS INFUSIONS
Screening in the DDC-primed Rat Model
Department of Anaesthetics, University of Cape Town South Africa
MRC Liver Research Group, Department of Medicine, University of Cape Town and Gardiner Institute, Department of Medicine, Western Infirmary, University of Glasgow
MRC Liver Research Group, Department of Medicine, University of Cape Town and Groote Schuur Hospital South Africa
The porphyrinogenicity of etomidate and ketamine administered as continuous i.v. infusions was screened in the DDC-primed rat model of latent variegate porphyria. Ketamine produced no change from control in 5-aminolaevulinate synthase (ALAs) activity and haem intermediate production in either untreated or DDC-primed rats, and would appear to be safe for use in the patient with genetic porphyria. Etomidate, while producing no significant changes in these parameters in untreated rats, caused a statistically significant 47% increase in hepatic ALAs activity with a corroborative 85% increase in coproporphyrin and a 40% increase in protoporphyrin content, in DDC-primed rats. On these grounds, etomidate must be regarded as potentially porphyrinogenic when administered as a continuous infusion for total i. v. anaesthesia.
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