Abstract
We report the case of a 3 year-old girl with a history of anaphylactic shock due to latex, who was successfully managed during the perioperative period. She underwent three operations for meningocele and exstrophy of the cloaca uneventfully. During central venous catheterization prior to the start of the fourth operation, an unexpected shock occurred and the operation was canceled. The shock was diagnosed as being caused by latex allergy. The diagnosis was established using the IgE-RAST latex test and skin prick tests. The operation was re-scheduled after recovery. To determine how to cope with latex allergy during the perioperative period, conferences were held among the medical staff, including surgeons, anesthesiologists, pediatricians, operating nurses, ward nurses, and ICU nurses. We determined whether surgical, anesthetic, and nursing implements ordinarily used contain natural latex material. All of the implements and devices containing latex such as surgical gloves, anesthetic circuits, and infusion routes were replaced with non-latex substitutes. Indispensable latex implements were wrapped to prevent direct contact with the patient's skin. Four months later, using latex-free procedures, the operation was performed uneventfully. In conclusion, avoiding latex exposure is possible in perioperative management of patients with latex allergy. In order to avoid latex exposure in such patients, communication and cooperation among medical staff members is essential. Continuing care instruction for patients' families is advised.
