Effects of anesthesia on tumor perfusion and infiltration during brain tumor neurosurgery

Brain tumor surgeries are among the most challenging procedures in neurosurgery, necessitating careful anesthetic management to achieve maximal tumor resection while preserving neurological function. Anesthesia affects key physiological parameters, including cerebral blood flow, intracranial pressure, and blood-brain barrier permeability, which are crucial in determining surgical outcomes. This mini-review examines the effects of various anesthetic agents, such as propofol, isoflurane, and sevoflurane, on tumor perfusion and infiltration, highlighting their potential to modulate tumor biology through mechanisms involving immune response, angiogenesis, and molecular pathways. The mini-review identifies critical gaps in the literature, particularly concerning the long-term impacts of anesthetic agents on tumor biology and patient survival, and calls for well-conducted randomized controlled trials to address these issues. Furthermore, it explores innovative strategies, including targeted anesthesia delivery and the integration of genomic and proteomic data, to enhance personalized patient care. By synthesizing current knowledge and identifying areas for future research, this mini-review aims to provide a foundation for optimizing anesthetic protocols in brain tumor surgeries to improve both short- and long-term patient outcomes.