Latex allergy in the operating room: case report and a brief review of the literature.

A patient with a history of spina bifida and cerebral palsy was anesthetized for an ileal conduit. The procedure was uneventful until penetration of the abdominal cavity, immediately after which the patient suffered severe hypotension and her peak inspiratory pressure doubled. The patient's skin became flushed and the capnogram tracing was consistent with bronchospasm. The patient was treated with phenylephrine hydrochloride (Neo-Synephrine), and then epinephrine. This was followed with an epinephrine infusion, intravenous (i.v.) methylprednisolone sodium succinate (Solu-Medrol), inhaled albuterol sulfate, and diphenhydramine hydrochloride (Benadryl) i.v.. The patient responded to these interventions and the procedure was completed without further incident. A diagnosis of latex allergy was made based on the patient's clinical status, underlying diseases, and positive postoperative radioallergosorbent test (RAST). Anesthesiologists must be able to diagnose the signs and symptoms of allergic reactions in patients under anesthesia. This article will review the types of hypersensitivity reactions involved, define the risk groups, and examine the treatment protocols available for latex allergy.