Table 2 Effects of anesthetics on cancer recurrence

Volatile anesthetics

-Pro-inflammatory and immunosuppressive action

-Reduces Th1/Th2 ratio

-Impairs NK cell activity

-Induces T cell and B cell apoptosis

-Upregulation of hypoxia-inducible factors (HIF-1α, HIF-2α,)

-Increase transcription of pro-metastatic factors (VEGF, angiopoietin-1, proteases MMP-2, and MMP-9)

-Enhanced tumor cell proliferation

-Increase angiogenesis, and cell migration

Intravenous anesthetics

-Anti-inflammatory and immunosuppression properties

-Suppression of prostaglandin and inflammatory cytokine production

-Inhibition of cyclooxygenase (COX) activity

-Stimulate the proliferation of NK cells

-Increase expression of granzyme B and IFNγ

-Increase cytotoxic T lymphocyte activity

-Does not affect the Th1/Th2 ratio

-Modulate genetic signaling pathways

-Inhibits histone acetylation

Ketamine, Thiopental

-Suppress the activity of NK cells

-Induce apoptosis in lymphocytes

-Inhibits the functional maturation of dendritic cells

-Reduce the synthesis of pro-inflammatory cytokines

Opioids

-Modulate wound healing

-Immunosuppression effects

-Inhibits natural killer cell activity

-Inhibits responses of T and B cells to mitogens

-Inhibits antibody production

-Promotes lymphocyte apoptosis,

-Reduces the differentiation of T cells

-Inhibits phagocytic activity

-Inhibits of the release of cytokine/ chemokine production

Local anesthetics

-Activates apoptotic pathway

-Inhibits tumor cell growth and migration

-Increases the activity of NK

-Increases the number of T-helper (Th) cells

-Preserves Th1/Th2 cells ratio

-Preserves IFN-gamma concentrations

-Modulates gene expression

-Increases IL-4 levels

-Decreases IL-10, IL-8, TNF-alfa production

NSAIDs and COX-2 inhibitors

-Inhibits the cyclooxygenase 1 and the cyclooxygenase 2

-Reduces prostaglandin synthesis

Paracetamol

-Inhibits prostaglandin endoperoxide H2 synthase and cyclooxygenase activity