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British Journal of Anaesthesia, 1991, Vol. 66, No. 1 60-65
© 1991 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

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

P. N. MEISSNER, B.SC.(MED.)(HONS), PH.D., G. G. HARRISON, M.D., F.C.ANAES. and R. J. HIFT, M.B., CH.B., M.MED.(MED.), F.C.P.(S.A.)

MRC/UCT Liver Research Centre, University of Cape Town Medical School Observatory 7925, South Africa
Department of Anaesthetics, University of Cape Town Medical School Observatory 7925, South Africa

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.


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