Anesthesia and the Porphyrias
作者:
DONALD MEES,
EVAN FREDERICKSON,
期刊:
Southern Medical Journal
(OVID Available online 1975)
卷期:
Volume 68,
issue 1
页码: 29-32
ISSN:0038-4348
年代: 1975
出版商: OVID
数据来源: OVID
摘要:
A simplified classification of the porphyrias is given which is thought to be advantageous to the anesthesiologist in determining those patients who are predisposed to acute attacks. These acute attacks may be precipitated by the administration of barbiturates, but may also be spontaneous. The current theory for the precipitation of the acute attack is described, with the probable mechanism being a decrease in uroporphyrinogen synthetase levels and the resultant interference in heme production. Increased formation of cytochrome P-450 with barbiturates also produces increased levels of delta aminolevulinic acid, which may be a cause of the acute attack. The significance in anesthesia and suggested means of anesthetic management are discussed.
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