LATEX ANAPHYLAXIS DURING SPINAL SURGERY IN CHILDREN WITH MYELOMENINGOCELE

Intra-operative anaphylaxis to latex involves cutaneous, respiratory a nd circulatory changes which may prove fatal if not promptly recognize d and treated. It is estimated that 18 to 40 per cent of children with spina bifida may be affected by latex allergy. Current tests availabl e lack sufficient sensitivity and specificity to be recommended as rou tine screening measures, therefore any allergic history in children wi th myelomeningocele should alert the clinician to the possibility that severe anaphylactic reactions may occur, especially when large mucosa l and pleural-peritoneal surfaces are exposed, as noted in the four re ported cases. Epinephrine is the drug of choice should a Type 1 reacti on occur.