title: Elective cholecystectomy performed on patient with variegate porphyria-Propofol-based total intravenous anesthesia with target-controlled infusion.
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.
authors.affiliation: Department and Clinic of General, Gastroenterological and Endocrine Surgery, Wroclaw Medical University, Wrocław, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Kuźmiński
authors.affiliation: Department and Clinic of General, Gastroenterological and Endocrine Surgery, Wroclaw Medical University, Wrocław, Poland. Electronic address: micapo@interia.pl.
authors.forename: Michał
authors.initials: M
authors.lastname: Aporowicz
authors.affiliation: Department and Clinic of Anesthesiology and Intensive Care, Wroclaw Medical University, Wrocław, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Brol
authors.affiliation: Department and Clinic of Anesthesiology and Intensive Care, Wroclaw Medical University, Wrocław, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Żołnowska
authors.affiliation: Department and Clinic of Anesthesiology and Intensive Care, Wroclaw Medical University, Wrocław, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Masternak
mesh_terms: D000768:Anesthesia, General / Q000379:methods*; D000771:Anesthesia, Intravenous / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D015415:Biomarkers / Q000652:urine; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000601:surgery; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D046350:Porphyria, Variegate / Q000150:complications* / Q000652:urine; D011166:Porphyrins / Q000652:urine; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D018686:Anesthetics, Intravenous; D015415:Biomarkers; D006993:Hypnotics and Sedatives; D011166:Porphyrins; D015742:Propofol
keywords: Anesthesia; Cholecystectomy; Porphyria; Propofol; Triggers