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Tuesday, June 27, 2017
Anesthesia for a patient with a family history of porphyria: Penothal for dental surgery and sulpha drugs for a bladder infection left me with side effects. I have not been diagnosed as having porphyria, but I do not want to percipitate an attack. I have seen the results in family members. What is safe for dental work?
Thank you for your question.
Routine dental treatment can be performed without problem. If IV sedation is used, barbiturates, such as methohexital and thiopental as well as etomidate, would be contraindicated. Otherwise, local anesthesia is fine as is sedation with midazolam and fentanyl, for instance. Nitrous oxide, or laughing gas, is fine as well. For post-operative pain, acetaminophen is good as are combinations of acetaminophen and commonly used opioids (narcotics). There should be no problem.
Steven I Ganzberg, SB, DMD, MS
Formerly, Clinical Professor of Dentistry
College of Dentistry
The Ohio State University