Is there a relationship between latex allergy and malignant
hyperthermia?
There is no known relationship between latex allergy and malignant
hyperthermia. Most likely a correlation was suspected due to severe
hypotension being a potential component of both latex allergy and
malignant hyperthermia (1).
As a point of information, one noted relationship between
malignant hyperthermia and latex does exist: Gilly et al. (2) noted
that anesthetic circuit tubing made of latex, in comparison to
rubber, polyethylene-vinyl-acetate (PEVA), silicone, and polysulfone,
had the highest residual content of volatile anesthetics even after
decontaminating procedures such as flushing with oxygen, thermal
disinfection and/or routine storage. However, a twenty-minute
flushing with oxygen (8 L/min) decreased effluent gas concentrations
below 5 p.p.m. in all tubing, a level deemed "safe" should a "clean"
machine not be immediately available.
Should plastic syringes with rubber plungers be
avoided?
Although glass syringes represent the ideal approach and plungers
from plastic syringes have been implicated in causing latex allergies
(3), Vasssallo et al. (4) note that they are often difficult to
locate, and suggest that if the contents of a syringe are immediately
injected after filling, presumably less antigens are released from
the plunger.
Where can more information on latex allergies be
obtained?
There are several sources of more information on latex
allergies.
- http://www.asahq.org/. The
ASA can be contacted for their recent publication: Task force on
latex sensitivity of the ASA committee on occupational health of
operating room personnel: Natural rubber latex allergy:
considerations for anesthesiologists. 1999. ASA, Park Ridge
IL.
- http://allergy.mcg.edu/.
The American College of Allergy, Asthma & Immunology.
- http://www.execpc.com/~alert/.
ALERT, Inc. Allergy to Latex Education & Resource Team,
Inc.
- http://members.tripod.com/claa/.
Canadian Latex Allergy Association.
- http://www.latex-allergy.org/.
ELASTIC. Education for Latex Allergy/Support Team &
Information Coalition).
- http://www.pals.net.
Physicians Against Latex Sensitization.
- http://www.sbaa.org/html/sbaa_latex.html.
Spina Bifida Association of America.
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References:
- Sigg DC, Iaizzo PA. Malignant hyperthermia phenotype:
hypotension induced by succinylcholine in susceptible swine.
Anesthesiology 2000;92(6):1777-88
- Gilly H, Weindlmayr-Goettel M, Koberl G, Steinbereithner K.
Anaesthetic uptake and washout characteristics of patient circuit
tubing with special regard to current decontamination techniques.
Acta Anaesthesiol Scand 1992;36(7):621-7.
- Kearns CF, Norris A. Latex allergy and plastic syringes.
Anesth Analg 1996;82:429.
- Vassallo SA, Kim SH, Todres ID. Latex allergy and plastic
syringes. Anesth Analg 1996;82:429.
Site Editor:
Stephen B. Corn, M.D. and B. Scott Segal, M.D.
Department of Anesthesia, Harvard Medical School
Founders
and Editors-in-Chief: Stephen B. Corn, M.D. and B. Scott Segal,
M.D.
Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School
