A Case of Intraoral Fire Due to Electrocauterization during Palatine Tonsil Extirpation

We experienced a fire in the mouth during palatine tonsil extirpation under general anesthesia. In this case, a dry cotton ball and tracheal tube caught fire when the surgeon used an electrocauterizer to stop the bleeding. Later, we measured the oxygen concentration that would be necessary to cause combustion of a cotton ball in the mouth. When oxygen concentration is 40% or more, electrocoagulation caused a fire, but when it is below 35%, electrocoagulation did not cause a fire. Our new protocole for tonsillectomy using an electrocauterizer is as follows : 1. Do not use dry cotton balls when an electrocauterizer is used. 2. Do not use an oxygen concentration of more than 30% when an electrocauterizer is used. 3. Use a suction device to decrease the oxygen concentration in the mouth cavity.