Intended for healthcare professionals

Rapid response to:

Clinical Review Regular review

Diagnosis and management of porphyria

BMJ 2000; 320 doi: (Published 17 June 2000) Cite this as: BMJ 2000;320:1647

Rapid Response:


Dear Sir - In the review of the ' Diagnosis and Management of
Porphyria' (Vol 320 17 June 2000: 16471650), by Thadani et al. they
comment on the risk of Surgery but place insufficient emphasis on the
potential hazards of anaesthesia for this group of patients. For patients
with porphyria anaesthesia carries a significant risk of morbidity and
mortality, most however, can now undergo
surgery with relative safety as a result of modern anaesthesia techniques
and the development of pharmacological agents with shorter half-lives.
improvements in anaesthesia safety depend on earlier detection of
susceptible patients and the identification of potentially porphyrinogenic
agents, neither of which may be readily achievable. Any patient with
proven or suspected porphyria should be referred for early anaesthetic
assessment if surgery is contemplated.

Susan deC Baker BSc (Hons). MBBS
Anaesthetic SHO

Dr Bruce Taylor FRCA
ITU Consultant, Queen Alexandra Hospital, Portsmouth


1. Harrison GG, Meissner PN and Hift RJ. Anaesthesia for the
porphyric patient. Anaesthesia 1993; 48 (417-421)

2. James MFM and Hift RJ. Porphyrias. British Journal of Anaesthesia
85 (1): 143-153 (2000)

3. Jensen NF, Fiddler DS, Striepe V. Anaesthetic considerations in
porphyrias. Anaesth Analog 1995; 80:591-599

4. Ashley EM. Anaesthesia for porphyria. Br J Hosp Med 1996;56: 37-42

Competing interests: No competing interests

25 July 2000
Susan de C Baker