Prolonged Loss of Consciousness and Elevated Porphyrins following Propofol Administrations

PORPHYRIA is an ecogenic disorder, often with pharmacologic agents playing an important role in its exacerbation. Propofol is a widely used anesthetic agent and is considered safe when administered to patients with porphyria. 1,12 Consciousness usually returns promptly after discontinuation of propofol administration, 2 We report a patient who had a prolonged alteration in consciousness, with multiple transient neurologic deficits and neuropathic pain after intravenous propofol administration. Urinary porphyrins were markedly elevated, including δ-aminolevulinic acid (ALA), porphobilinogen, and coproporphyrin III. The likely possibility of propofol exacerbating previously undiagnosed coproporphyria is discussed.