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Cytokines and anesthesia

BACKGROUND AND OBJECTIVES: Cytokines can be stimulated and released by surgical injury, trauma, infection, inflammation and cancer. High cytokine circulating levels may lead to complications and delay of postoperative recovery. This study review and summarizes available information on cytokines. CONTENTS: Cytokines are polypeptide molecules produced by a wide variety of cells, which seem not to play a role in homeostasis under normal conditions. These mediators are responsible for local or systemic responses and produce immune, metabolic, hemodynamic, endocrine and neural changes. They may activate beneficial biologic responses, such as antimicrobial function stimulation, wound healing, myelostimulation and substrate mobilization. However, abundant cytokine secretion is associated to deleterious effects, such as hypotension, organ failure and death. CONCLUSIONS: In closing this review, it is clear that cytokines have a fundamental role as metabolic, hormonal, immune and hematological response mediators; that there is a therapeutic potential for their expression block; and that anesthesia may interfere in their activation. However, several questions are still to be answered and further studies are needed to explain cytokine actions not only for experimental, but also for clinical purposes.

CYTOKINES


Sociedade Brasileira de Anestesiologia R. Professor Alfredo Gomes, 36, 22251-080 Botafogo RJ Brasil, Tel: +55 21 2537-8100, Fax: +55 21 2537-8188 - Campinas - SP - Brazil
E-mail: bjan@sbahq.org