Bladder cancer is one of the most commonly diagnosed malignancies of the genitourinary system with an expected 81,400 new cases and 17,980 deaths in the United States for 2020.1 While radical cystectomy with bilateral pelvic lymphadenectomy remains the gold standard treatment for surgically eligible patients with either non-metastatic muscle-invasive disease (MIBC)2 or persistent high-grade non-MIBC,3 at the time of surgical resection there might be an increase in shedding of cancer cells into the circulation.4 Recent reports have found that roughly 32% of patients after five years from surgery experience recurrence.5 In addition to surgery itself, several other surgical factors, one of which being anesthetic technique may suppress anti-tumor immunity allowing circulating cancer cells to survive and enhance migration and invasion at a target site.4