Kisch H, Jacobs P, Thiel M
Institut für Anaesthesiologie, Klinikum Grosshadern, Ludwig-Maximilians-Universität München.
Anaesthesist. 1996 Jul;45(7):587-96. doi: 10.1007/s001010050291.
Immediate-type hypersensitivity due to natural rubber (latex) products is an increasing problem for the anaesthetist, because a major part of products used for anaesthesia contains natural rubber. If the patient has a positive history of allergic symptoms after contact to natural rubber like urticaria, bronchospasm or anaphylaxis, preoperative skin tests, in vitro tests, and if necessary even the latex-glove-wearing test should be performed. If preoperative diagnosis of natural latex allergy is established, latex free anaesthesia is strictly recommended; otherwise life-threatening complications may ensue. Accordingly, we report on a patient who developed intraoperative anaphylactic shock following exposure to natural latex. In addition to the treatment with drugs, latex-containing products should be immediately replaced by latex-free ones, in particular all persons should put on latex-free gloves. For prevention of anaphylactic episodes in sensitized patients the reader is provided with an exemplary list of latex-free products for anaesthesia. Because the incidence of immediate-type reactions to latex is still increasing, intraoperative occurrence of an anaphylactic reaction to an unknown agent is likely to be due to allergy to natural rubber.
天然橡胶（乳胶）制品引起的速发型超敏反应对麻醉医生来说是一个日益严重的问题，因为用于麻醉的大部分产品都含有天然橡胶。如果患者在接触天然橡胶后有过敏症状的阳性病史，如荨麻疹、支气管痉挛或过敏反应，应进行术前皮肤试验、体外试验，必要时甚至应进行戴乳胶手套试验。如果术前确诊为天然乳胶过敏，强烈建议采用无乳胶麻醉；否则可能会出现危及生命的并发症。因此，我们报告了一名患者在接触天然乳胶后发生术中过敏性休克的病例。除了药物治疗外，含乳胶产品应立即更换为无乳胶产品，特别是所有人都应戴上无乳胶手套。为预防致敏患者发生过敏反应，为读者提供了一份麻醉用无乳胶产品的示例清单。由于对乳胶的速发型反应发生率仍在上升，术中对未知药物发生过敏反应很可能是由于对天然橡胶过敏。
