Intraoperative latex hypersensitivity: do not overlook
Philip D. Bailey Jr. DO (Attending Anesthesiologist)
John L. Bastien MD (Attending Anesthesiologist)
Department of Anesthesiology, Naval Medical Center, Portsmouth, VA 23708, USA
Received 21 June 2004; accepted 25 October 2004
Abstract We report a case of intraoperative latex hypersensitivity to Penrose surgical drains (Ansell,
Massillon, Ohio). To our knowledge, there has been no previous report of such a reaction with this device.
D 2005 Elsevier Inc. All rights reserved.
Latex use in the hospital setting has dramatically
decreased over time because of recognition of latex-
related adverse reactions in both patients and health care
workers. Although most hospitals are making efforts to
replace latex products with latex-free alternatives, many
operating rooms (ORs) still use products known to
contain latex. Whereas intraoperative hypersensitivity
reaction to latex-containing gloves has been reported ,
there has been no previously reported case of hypersen-
sitivity reaction to Penrose surgical drains (Ansell,
Massillon, Ohio). We report a case of an apparent
intraoperative latex hypersensitivity reaction attributed to
a Penrose surgical drain.
2. Case report
A 12-year-old, 30-kg girl with Lennox-Gestaut syndrome,
pseudobulbar palsy, spastic cerebral palsy, cortical blindness,
and esophageal reflux disease presented for removal of a
large, asymptomatic thyroid mass. The patientTs past surgical
history was remarkable for multiple surgical procedures. She
had no known drug or food allergies or any history of latex
hypersensitivity. Her current pharmaceutical regimen at the
time of surgery included lorazepam, levetiracetam, top-
iramate, felbamate, ranitidine, erythromycin, and albuterol.
Her preoperative laboratory evaluation was remarkable for a
thyroid stimulating hormone (TSH) of 0.94 mU/mL (normal,
0.35-5.50 mU/mL) and a free T4 level of 0.85 lg/dL
(normal, 0.89-1.80 lg/dL).
The patient was transferred to the OR and placed on the
OR table where standard ASA monitors were applied. Her
baseline heart rate (HR) and blood pressure (BP) were
90 beats per minute (bpm) and 101/52 mm Hg, respec-
tively. An inhalation induction was performed with 8%
sevoflurane, and the trachea was successfully intubated
0952-8180/$ – see front matter D 2005 Elsevier Inc. All rights reserved.
Disclaimer: the views expressed in this article are those of the
authors and do not reflect the official policy or position of the Department
of the Navy, Department of Defense, or the United States Government.
T Corresponding author. Tel.: +1 757 953 3238; fax: +1 757 953 0871.
E-mail address: firstname.lastname@example.org (P.D. Bailey).
Penrose surgical drain;
Journal of Clinical Anesthesia (2005) 17, 485 – 487