Pectus excavatum repair in a patient with prune belly syndrome

We describe the anaesthetic management of a child with ‘Prune Belly’ syndrome who was presented for repair of pectus excavatum. In addition to having severe restrictive lung disease, the patient was also asthmatic. Prior surgical procedures had resulted in long term debilitation because of pulmonary complications. Principles of anaesthetic management first described more than twenty years ago were utilized and combined with an effective perioperative pain management plan to provide for a smooth and satisfactory postoperative outcome. Repair of the patient's pectus excavatum deformity improved his respiratory mechanics, while the use of thoracic epidural anaesthesia in the immediate perioperative period allowed rapid improvement in pulmonary function.