Latex anaphylaxis during spinal surgery in children with myelomeningocele.

Intra-operative anaphylaxis to latex involves cutaneous, respiratory and circulatory changes which may prove fatal if not promptly recognized and treated. It is estimated that 18 to 40 per cent of children with spina bifida may be affected by latex allergy. Current tests available lack sufficient sensitivity and specificity to be recommended as routine screening measures, therefore any allergic history in children with myelomeningocele should alert the clinician to the possibility that severe anaphylactic reactions may occur, especially when large mucosal and pleural-peritoneal surfaces are exposed, as noted in the four reported cases. Epinephrine is the drug of choice should a Type 1 reaction occur.