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

## TL;DR

A new method using snorkel breathing with sevoflurane is described to safely induce anesthesia in a patient afraid of masks and needles.

## Contribution

A novel snorkel breathing technique is introduced for anesthetic gas induction in patients with mask and needle phobia.

## Key findings

- The snorkel technique allowed successful anesthesia induction in a patient with mask and needle fear.
- The patient cooperated well during the procedure, enabling intravenous cannula insertion.
- Sevoflurane at 8% dial setting with 6 L/min fresh gas flow was effective for induction.

## Abstract

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.