CASE REPORT
Year : 2015  |  Volume : 9  |  Issue : 1  |  Page : 82-85

Anesthesia for hemicolectomy in a known porphyric with cecal malignancy


Department of Anesthesia, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India

Correspondence Address:
Dr. Shagun Bhatia Shah
H. No. 174-175, Ground Floor, Pocket-17, Sector-24, Rohini, New Delhi - 110 085
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1658-354X.146320

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Intraoperative management of a known acute intermittent porphyria patient is a challenge requiring awareness of factors, which trigger an acute crisis, clinical features of a porphyric attack, knowledge of safe pharmacologic intervention, and preparedness for reintubation and ventilatory support. The classical signs of a porphyric crisis such as pain abdomen, vomiting and neuropsychiatric symptoms are masked under general anesthesia and can be confused with postoperative pain and vomiting and postoperative cognitive dysfunction, especially for intra-abdominal surgeries. Eternal vigilance for onset of an acute crisis is imperative. After a crisis of acute intermittent porphyria, residual paresis may persist for years in the absence of further attacks.


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