Propofol-based anesthesia has been reported to reduce the recurrence and metastasis of a number of cancer types following surgical resection. However, the effects of propofol in bladder cancer (BC) are yet to be fully elucidated. The aim of the present study was to investigate the functions of propofol in BC and their underlying mechanisms. In the study, the expression of microRNA (miR)-145-5p in BC tissues and cell lines was evaluated using reverse transcription-quantitative PCR, and the effects of propofol on BC cells were determined using cell viability, wound healing and Transwell cell invasion assays, bioinformatics analysis, western blotting, immunohistochemistry and in vivo tumor xenograft models. It was found that propofol significantly suppressed the proliferation, migration and invasion of BC cells in vitro. In addition, propofol induced miR-145-5p expression in a time-dependent manner, and miR-145-5p knockdown attenuated the inhibitory effects of propofol on the proliferation, migration and invasion of BC cells. Topoisomerase II α (TOP2A) was a direct target of miR-145-5p, and silencing TOP2A reversed the effects of miR-145-5p knockdown in propofol-treated cells. Furthermore, propofol suppressed tumor xenograft growth, which was partially attenuated by miR-145-5p knockdown. The present study provided novel insight into the advantages of surgical intervention with propofol anesthesia in patients with BC. © 2021 Spandidos Publications. All rights reserved.