Snorkel breathing technique in anesthesia: A narrative review

Abstract The purpose of this narrative review is to investigate the existing evidence supporting the use of the snorkel breathing technique in anesthesia practice. In addition, this review aims to identify certain patient scenarios where the snorkel breathing approach can be appropriate. A total of nine articles relevant to anesthesia and airway management were retrieved using the search strategy. A review of the final papers found that the snorkel breathing technique offers a few advantages over using a regular face mask in the operating room. The snorkel or mouthpiece breathing approach can be as effective as the traditional face mask for successful preoxygenation, as defined by an end-tidal oxygen concentration greater than 0.9. The snorkel breathing approach can be a viable option in patient populations where face mask application is challenging. It also has greater acceptance than the face mask among patients and healthy volunteers. Another advantage of the snorkel breathing technique is that it can be utilized to provide apneic oxygenation during rapid sequence induction using short-acting neuromuscular blocking drugs, reducing the use of plastic (face mask). For older children and claustrophobic adults who are apprehensive about masks, snorkel gas induction can make anesthesia induction smoother and more pleasant. The snorkel breathing technique has potential application in certain anesthetic scenarios, and this narrative review also incorporates the author’s clinical experience with it. To validate the effect of this novel technique (snorkel preoxygenation and snorkel gas induction) on patient-centered outcomes, more randomized controlled trials are required.