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The mechanism by which NMU induces mutations is primarily through its alkylating properties. Upon exposure, NMU can add alkyl groups to DNA bases, leading to mispairing during DNA replication. This results in transitions or transversions in the nucleotide sequence, which can ultimately lead to permanent mutations. If these mutations occur in critical genes responsible for regulating cell growth and division, such as proto-oncogenes and tumor suppressor genes, they may lead to uncontrolled cell proliferation and cancer.
nitroso methyl urea

Sevoflurane also affects the respiratory system. It causes a relaxation of the muscles in the airways, which can lead to a decrease in respiratory effort. To counteract this effect, patients are typically provided with mechanical ventilation, where a ventilator assists with breathing throughout the surgery. This ensures that the patient receives enough oxygen and expels carbon dioxide efficiently.