Sevoflurane Induction With Snorkel Technique in an Adult With Mask and Needle Phobia

Snorkel breathing involves mouth breathing into a snorkel tube and is necessary for underwater activities. Anesthesiologists may have difficulty when dealing with adults who have a concomitant face mask and needle fear because both inhalation and intravenous induction cannot be performed. This case report describes a novel use of the snorkel breathing technique for anesthetic gas induction in an adult with face mask fear. A 24-year-old female with mask and needle fear underwent a craniotomy and biopsy of a frontal lesion while under general endotracheal anesthesia. During anesthesia induction, the patient was directed to hold the breathing tube tightly between her lips and breathe via her mouth into it with sevoflurane at 8% dial setting and 6 L/min of fresh gas flow. The snorkel approach was effectively used to induce anesthesia with better patient cooperation, and an intravenous cannula was inserted.