Sánchez-Ródenas L, Sánchez-Ortega J L
Servicio de Anestesiología y Reanimación, Hospital Universitario Virgen de la Arrixaca, Murcia.
Rev Esp Anestesiol Reanim. 2005 Feb;52(2):101-4.
Latex allergy is a cause of anaphylactic reactions during general anesthesia. It is currently the second most common cause of anaphylaxis during anesthesia and should be considered in all cases in which signs develop during surgery. Clinical manifestations are highly variable and depend on the type and amount of exposure to the allergen as well as on individual sensitivity. Cardiovascular collapse is the most common presentation in anesthetized patients, and the second most common manifestations are skin rash and bronchospasm. Latex gloves are implicated in most allergic reactions triggered by latex. Individuals allergic to latex are also sensitive to certain fruits (latex-fruit syndrome) because the presence of specific proteins common in both causes a phenomenon known as cross reactivity. A 34-year-old man with acute abdomen underwent emergency exploratory laparoscopy, which was converted to laparotomy based on findings in the surgical field. Coinciding with surgical manipulation, the patient developed severe hypotension, tachycardia, bronchospasm, and arterial desaturation, which responded favorably to intravenous fluids and medication. After all other possible causes of the events were ruled out, intraoperative anaphylactic reaction was suspected and later confirmed by tests, including allergy tests. When the patient was stable and the surgical environment was latex-free, the procedure was carried out with no complications and the postoperative course was uneventful.
乳胶过敏是全身麻醉期间发生过敏反应的一个原因。它目前是麻醉期间过敏反应的第二大常见原因,在手术过程中出现症状的所有病例中都应予以考虑。临床表现高度多变,取决于接触过敏原的类型和数量以及个体敏感性。心血管虚脱是麻醉患者最常见的表现,第二常见的表现是皮疹和支气管痉挛。大多数由乳胶引发的过敏反应都与乳胶手套有关。对乳胶过敏的个体对某些水果也敏感(乳胶-水果综合征),因为两者中都存在的特定蛋白质会引发一种称为交叉反应的现象。一名34岁的急腹症男性患者接受了急诊探查性腹腔镜检查,根据手术视野中的发现转为开腹手术。与手术操作同时,患者出现严重低血压、心动过速、支气管痉挛和动脉血氧饱和度下降,经静脉输液和药物治疗后情况好转。在排除了所有其他可能导致这些事件的原因后,怀疑术中发生过敏反应,后来通过包括过敏试验在内的检查得以证实。当患者情况稳定且手术环境无乳胶时,手术顺利进行,术后过程平稳。