LOCAL ANAESTHESIA AND PORPHYRIA. IS TOTALCAINE FORTE A SAFE DRUG FOR PORPHYRIC PATIENTS?

MARIA DEL CARMEN MARTINEZ; JOHANNA ZUCCOLI; ALCIRA BATLLE; ANA MARIA BUZALEH

Burdeaux

Congreso; INTERNATIONAL CONGRESS ON PORPHYRINS AND PORPHYRIAS 2017; 2017

Acute attacks of Porphyria may be precipitated by exogenous drugs including anaesthetics. There is limitedinformation in the literature about the use of some dental medicines in the acute Porphyrias. The safety oflocal anaesthetic agents remains a controversial issue due to experimental evidence reveals that some ofthem are porphyrogenic in either animal models (lidocaine) or cell culture (lidocaine, prilocaine,bupivacaine), however clinical experience has shown no notable adverse effect in patients with AcutePorphyria. Articaine (carticaine, methyl-4-methyl-3-(2-propylaminopropionamide) thiophene-2-carboxylatehydrochloride) Is a relatively new local anaesthetic and still untried in Acute Porphyria, although somereports established its safety and others classified this drug as unsafe. The aim was to investigate the effectof a commercial preparation, Totalcaina Forte (carticaine chlorhidrate:L-adrenaline, Bernabo Laboratories)on heme metabolism. Animals (CF1 mice) received different doses (1, 5 and 7 mg/kg, s.c.) and weresacrificed at different times (30 and 60 minutes) after injection. 5-Aminolevulinic acid synthetase (ALA-S),Porphobilinogen deaminase (PBG-D) and Heme oxygenase (HO) were measured in liver, brain and blood.Results indicated that ALA-S and PBG-D activity remain unchanged at low doses. Although, in animalsreceiving 7 mg/kg a slight reduction of liver PBG-D was found. The induction of HO activity (67%, p