Clinical management of latex-allergic children.
Latex allergy in children with myelodysplasia and urological anomalies is well recognized. We anesthetized 162 children with latex allergy who underwent 267 anesthetics according to a latex-safe protocol. Medication for allergy prophylaxis was not administered. Our patients were 11.6 +/- 5.8 yr old (range 1-31 yr). Primary diagnoses were myelodysplasia, extrophy of the bladder, and cloacal extrophy. These children had many allergies to medications and foods as well as environmental sensitivities. One patient of 162 (1 procedure of 267) had an allergic reaction after injection of an epidural catheter with bupivacaine and fentanyl. No other patient manifested allergy signs or symptoms. Latex-allergic children can be safely anesthetized using a latex-safe protocol without allergy chemoprophylaxis. These patients require avoidance of latex products or the use of latex products that have been thoroughly washed.


CONCLUSIONS
This audit of the medical histories and treatment of 162 children with latex allergy who underwent 267 anesthetics indicates that latex-allergic children can be safely anesthetized if exposure to latex in the medical environment is avoided, and that administration of prophylactic medications to decrease the allergic response is unnecessary.
Holzman
R S
RS
Department of Anesthesiology, Children's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA. Holzman@a1.tch.harvard.edu
D000293:Adolescent; D000328:Adult; D000707:Anaphylaxis / Q000139:chemically induced / Q000517:prevention & control; D000758:Anesthesia; D002648:Child; D002675:Child, Preschool; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D007223:Infant; D007431:Intraoperative Complications / Q000517:prevention & control; D007840:Latex / Q000009:adverse effects*
D007840:Latex