Immune response and metabolic regulation are highly integrated and the proper function of each is dependent on the other. Cytokines are helpful towards the host response but potentially hazardous if uncontrollable or in excess. This review evaluated the role of cytokines in the metabolic response to surgery and the association with the new insight of enhancing recovery after surgery. Surgery is a stressor that affects homeostasis. Excess cytokines cause insulin resistance and thus type-2

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... s through a complex immuno-physiological response to surgery. A precise understanding of the cytokine response to surgical trauma may bring in interventions that would optimise the perioperative care of the patient, decrease morbidity and enhance recovery. Methods: Electronic searches of the medline (PubMed) database, Cochrane library and science citation index were performed to identify original published studies on cytokines and metabolism, and enhanced recovery after surgery. Relevant articles were searched from relevant chapters in specialized texts and all included.