IP Requirement: Emory IP

Experience Requirement:

– Mechanical Design

– Rapid Prototyping

Background

Inhalational induction of anesthesia, particularly with agents such as sevoflurane, is often associated with a pungent smell that can cause distress, anxiety, and resistance in pediatric and adult patients. Inhalational induction remains common in pediatric anesthesia due to the avoidance of IV placement and the rapid onset of volatile agents. However, the sharp odor of sevoflurane is frequently distressing to children, resulting in:

• – Crying, struggling, or agitation during mask application
• – Increased induction time
• – Higher rates of parental and staff distress
• – Negative perioperative memory formation

Current strategies to facilitate the ease of inhalational induction include pre-medication (midazolam, ketamine, dexmedetomidine, etc.) and flavored masks. Studies support the use of scent or flavoring during anesthesia induction.1,2

Current Method for Scent Delivery at Arthur M. Blank

Presently, our scent delivery system is to rub chapstick or liquid sent via tip applicator on the inner part of the face-mask that will eventually rest on the child’s face where they will breathe oxygen and eventually anesthesia. To give them choices, we describe the possible flavors (watermelon, strawberry, etc.) during our preoperative evaluation or allow them to smell the flavors in the OR prior to smearing them on the mask. Most scents are reused as long as there are no concerns for contamination (a child unintentionally licks the scent and/or places nose directly onto the tube when picking). 

Objective 

Create a simple, low-cost innovation to reduce preoperative anxiety, improve cooperation during mask induction, and enhance the overall patient experience – especially children. Additionally create a sanitary delivery system that can be reused for multiple surgical cases, while allowing the child to accurately experience and pick their personal scent. 

The Device

We propose the integration of a scent diffuser attachment into the anesthesia circuit to deliver pleasant, non-toxic aromatics (e.g., vanilla, bubblegum, or lavender) during induction. A scent diffuser integrated directly into the circuit could provide an effective, non-pharmacologic enhancement of the induction process. The device should be a small, disposable or reusable cartridge containing essential oil microcapsules. The device could clip securely onto the inspiratory limb of the anesthesia circuit or within the face mask dome. Mechanisms of function could be flow-activated release of scent upon fresh gas flow or humidity/heat activated. The following could be other features of the device, 

1. – Compatible with common mask sizes and circuit types
2. – Sterile, latex-free, and hypoallergenic materials
3. – Have adjustable scent concentration via flow control.
4. – Scent selection capability based on patient preference. 

 References

– Abukawa, Yukako et al. “The use of a scented face mask in pediatric patients may facilitate mask acceptance before anesthesia induction.” Frontiers in medicine vol. 10 1190728. 2 Jun. 2023, doi:10.3389/fmed.2023.1190728

– Wotman, Michael et al. “The Efficacy of Lavender Aromatherapy in Reducing Preoperative Anxiety in Ambulatory Surgery Patients Undergoing Procedures in General Otolaryngology.” Laryngoscope investigative otolaryngology vol. 2,6 437-441. 8 Nov. 2017, doi:10.1002/lio2.121​