Table 1.
Effects and mechanisms of general anesthetic agents on tumor progression.
| Agents | Effect | Presumed mechanism of action |
|---|---|---|
| Ketamine | + | Inhibits NK cell activity8 |
| Thiopental | + | Decreases number of circulating NK cell and promotes tumor metastasis9 |
| Propofol | − | Inhibits MMP and prevents tumor spread10 |
| Benzodiazepines | N | Controversial role17 |
| Inhalational agents | + | Promotes apoptosis of NK cell and human T lymphocytes and promotes tumor metastasis11 |
| Nitric oxide | + | Interferes with DNA, purine and thymidylate synthesis, inhibits neutrophil function, promotes tumor metastasis12,13 |
| Muscle relaxants | N | No effect on tumor progression |
| Opioids | + | Promotes angiogenesis and immunosuppression14,15 |
| NSAIDS | − | Anti-angiogenesis and inhibits tumor spread16 |
MMP, matrix metalloprotein; NSAIDS, non-steroidal anti-inflammatory drugs
“+”, pro-tumor; “−”, anti-tumor; “N”, no definite effects