Carcinoid syndrome: its relevance to the anaesthetist

This paper presents the pathology, pharmacophysiology and therapy of the carcinoid syndrome. Forty reports from the literature are reviewed and the anaesthetic management of the patients is discussed. The carcinoid syndrome is a rare multihumoral endocrine disease. Secretions may be stimulated by certain anaesthetic and surgical manoeuvres and produce undesirable, and occasionally fatal, cardiovascular and respiratory complications. A radical surgical approach to the disease is current. Anaesthetists may therefore be involved in the management of these patients more frequently than before. The implication of both serotonin and bradykinin in the pharmacophysiology of this disease allows a more rational approach to the treatment of complications occurring during anaesthesia. However, other, as yet undiscovered vasoactive substances, may be involved.