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[丙泊酚与阿曲库铵用于迟发性皮肤卟啉症患者的麻醉]

[Anesthesia with propofol and atracurium in a case of porphyria cutanea tarda].

作者信息

Baratto F, Meggiolaro M

机构信息

Istituto di Anestesiologia e Rianimazione, Università degli Studi, Padova.

出版信息

Minerva Anestesiol. 1998 Nov;64(11):535-9.

PMID:9951273
Abstract

The conduction of anaesthesia in a patient with a diagnosis of porphyria cutanea tarda is described. The aim of this paper is to provide further evidence for safety of TIVA (Total Intra Venous Anaesthesia) paying particular attention to propofol and atracurium (there are not sufficient data about it in the literature) in patients with porphyria cutanea tarda and high levels of uroporphyrin. The study of the anaesthetic management of a patient suffering from Porphyria Cutanea Tarda (PCT), the most common form of porphyria, can offer useful indications. Due to the fact that PCT is less severe than the acute forms, there is less risk for the patient under anaesthesia. In this particular case preoperative, intraoperative and postoperative urinary porphyrin are compared and furthermore, the liver function and the eventual development of skin lesions are monitored. A not significant increase of urinary porphyrin levels after surgery, no skin lesions and no modifications of liver function have been observed. TIVA proved to be safe in this case of PCT.

摘要

本文描述了对一名诊断为迟发性皮肤卟啉症患者实施麻醉的过程。本文旨在为全凭静脉麻醉(TIVA)的安全性提供进一步证据,尤其关注丙泊酚和阿曲库铵(文献中关于此的资料不足)在迟发性皮肤卟啉症且尿卟啉水平较高患者中的安全性。对最常见的卟啉症类型——迟发性皮肤卟啉症(PCT)患者的麻醉管理进行研究,可提供有用的参考。由于PCT不如急性型严重,患者在麻醉下的风险较小。在这个特殊病例中,对术前、术中和术后的尿卟啉进行了比较,此外,还监测了肝功能和皮肤病变的最终发展情况。术后未观察到尿卟啉水平有显著升高,未出现皮肤病变,肝功能也未发生改变。在该PCT病例中,全凭静脉麻醉被证明是安全的。

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