Reversing the triad of anaesthesia in a cannot intubate, cannot oxygenate emergency

Editor—Anatomical abnormalities of the larynx and trachea are frequently overlooked during a preanaesthetic evaluation if the patient is asymptomatic for an airway abnormality. 1 Gelbard A. Francis D.O. Sandulache V.C. Simmons J.C. Donovan D.T. Ongkasuwan J. Causes and consequences of adult laryngotracheal stenosis. Laryngoscope. 2015; 125: 1137-1143 Google Scholar The triad of general anaesthesia includes loss of consciousness, analgesia, and immobility. We successfully managed a cannot intubate, cannot oxygenate (CICO) emergency by reversing the triad of anaesthesia, which included reversing the loss of consciousness effect of remimazolam with flumazenil, the analgesic effect of sufentanil with naloxone, and the neuromuscular block of rocuronium with sugammadex. This approach to reversing the triad of anaesthesia could be an option in some difficult clinical circumstances.