EFFECT OF CERTAIN ANAESTHETIC AGENTS ON THE ACTIVITY OF RAT HEPATIC Δ-Aminolaevulinate SYNTHASE

Abstract

The activity of delta-aminolaevulinic acid synthase (E.C.2.3.1.37) (the rate-limiting enzyme for haem and porphyrin biosynthesis) has been measured in the rat liver after the repeated administration of anaesthetic agents in vivo. The activity of the enzyme was increased by Althesin, chlordiazepoxide, enflurane, etomidate, lignocaine, methohexitone, methoxyflurane, pentazocine and thiopentone and decreased by procaine. No significant changes in activity occurred after the administration of amethocaine, atropine, bupivacaine, diazepam, droperidol, halothane, ketamine, morphine, nitrous oxide, pethidine, phenoperidine, prilocaine and propanidid. It is suggested that those anaesthetic agents which induced activity of the enzyme should not be administered to patients with an acute porphyria.

Induction of delta‐aminolaevulinic acid synthase in leucocytes of patients on phenytoin therapy‐comparison with changes in rat hepatic tissue.

“…The liver was then excised, chilled in ice and blotted dry. Aliquots were taken and weighed for ALA synthase and cytochrome P450 determination by the methods of Parikh & Moore (1978) and Omura & Sato (1964) respectively. Heparinized venous blood (30 ml) was required for the determination of the leucocyte ALA synthase activity.…”

Safety of isoflurane and epidural anesthesia in a patient with hereditary coproporphyria

“…We speculate that the epidural analgesia was effective in reducing not only surgical stress during operation but also postoperative pain, and that it resulted in the absence of acute attack. Parikh and Moore examined various agents in a rat model which suggested that procaine and bupivacaine are safe agents, but that lidocaine should be avoided [16]. There is no evidence that the use of bupivacaine in a regional anesthetic technique precipitates an attack of acute intermittent porphyria [6].…”

Desfluran bei akute intermittierender Porphyrie

“…Lange Zeit wurde [14,16]. Den Berichten einer möglichen Assoziation mit Halothanapplikation widersprechen experimentelle und klinische Erfahrungen [7,13,21].Im Tierversuch konnte Enfluran als porphyrinogen identifiziert werden [4,22]; es fehlen aber klinische Korrelationen. Isofluran erscheint aufgrund einiger Berichte [4,7,14,16,17,21] als sicher; allerdings sollten noch weitere Daten erhoben werden [14,16].…”

“…Da wir in unserem perioperativen anästhe-siologischen Management die frühzeiti-ge Extubation bei absoluter Schmerzfreiheit anstrebten, entschlossen wir uns, einen thorakalen Periduralkatheter bei Th 8/9 zu legen.Der neurologische Status der Patientin wurde vorher durch einen Neurologen dokumentiert. Wir verwendeten Bupivacain, das als sicher gilt [14,22]. Die spinale Testung erfolgte mit 3 ml 0,5%igem Bupivacain.Auf eine Hauptdosis zum Hautschnitt verzichteten wir bewusst, um eine hämodynamische Instabilität bei evtl.…”