Canadian Journal of Anesthesia, Vol 10, 286-296, Copyright © 1963 by Canadian Anesthesiologists' Society

Porphyria as a Problem in Anaesthesia

¹ St. Mary's Hospital, Montreal, P.Q.

Porphyria represents a basic metabolic disturbance and appears in many forms. Two of these, both acute, are of importance to the anaesthesiologist. It is a difficult disease to recognize because it can simulate so many other abdominal emergencies. When confronted with these emergencies, only an awareness of the disease and a knowledge of its intricacies will suggest the possibility that this condition is present and lead to testing of the urine for porphobilinogen.

The future treatment of the disease may hold a large role for the anaesthesiologist. Severe neurological involvement with respiratory failure may soon be treated in the respiratory unit and then, perhaps, the high mortality rate can be lowered.

Dundee² feels that this disease is possibly the only single absolute contraindication to using thiopentone as an induction agent. All other anaesthetic agents, with the possible exception of neostigmine and regional techniques, may be employed.

Note:

Presented at the weekly Geigy meeting of the McGill Diploma Course, February, 1963.