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REPLY Ventilation in patients with tracheal obstruction can create serious problems, particularly when the cross-sectional diameter of the trachea is narrowed to 5-6 mmHg. That is why the anaesthetic management and method of ventilation in our patient followed a step-by-step algorithm to ensure safety. The anaesthetic plan started by awake tracheal intubation, to be followed by spontaneous inhalation anaesthesia in 100% oxygen. Neuromuscular blockade and controlled ventilation were initiated after ensuring adequate jet ventilation. In his letter, Dr. Agarwal shouM have agreed with us, rather than disagreed, since we shifted to controlled ventilation as soon as we ensured its safety.

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