A patient with porphyria can usually undergo surgery provided certain precautions are taken. However, surgery should only be performed if it is necessary and likely to have benefits that outweigh any risks.


Risk factors for surgery:

(1) history of acute porphyria (associated with the neurovisceral types - AIP, VP, HCP and ALADD) AND frequent attacks

(2) prolonged fasting and stress

(3) administration of triggering medications





atropine and morphine

induction agent for anesthesia

propofol or ketamine

muscle relaxation

D-tubocurarine or suxamethonium

general anesthesia

nitrous oxide AND intravenous narcotics AND muscle relaxants

regional anesthesia (preferred if possible)



morphine, diamorphine, pethidine, or fentanyl

carbohydrate source

intravenous infusion of dextrose starting before surgery and continuing until the patient is able to tolerate a regular diet


If the patient has a problem with photosensitivity, then prolonged exposure to bright operating room lights may be a hazard.


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