There are controversial data about the effect of carotid endarterectomy regarding postoperative cognitive function. Our aim was to analyze the effect of cerebral tissue saturation monitored by near-infrared spectroscopy (NIRS) on cognitive function. Perioperative data of 103 asymptomatic patients undergoing elective carotid surgery under general anesthesia were analyzed. Preoperatively and 3 months after the operation, MMSE (Mini Mental State Examination) and MoCA (Montreal Cognitive Assessment) tests were conducted. For cerebral monitoring, NIRS was used, and the lowest rSO₂ value and the degree of desaturation were calculated. Cognitive changes were defined as one standard deviation change from the preoperative test scores, defined as postoperative neurocognitive decline (PNCD) and cognitive improvement (POCI). PNCD was found in 37 patients (35.92%), and POCI was found in 18 patients (17.47%). Female gender, patients with diabetes, and the degree of desaturation were independently associated with PNCD. The degree of desaturation during the cross-clamp period negatively correlated with the change in the MoCA scores (R = − 0.707, p = 0.001). The 15.5% desaturation ratio had 86.5% sensitivity and 78.8% specificity for discrimination. For POCI, a desaturation of less than 12.65% had 72.2% sensitivity and 67.1% specificity. POCI was associated with lower preoperative MOCA scores and a lower degree of desaturation. We found a significant relation between the change of postoperative cognitive function proven by the MoCA test and cerebral tissue saturation during the clamping period in patients undergoing carotid endarterectomy.

关于颈动脉内膜切除术对术后认知功能的影响存在争议。我们的目的是分析近红外光谱（NIRS）监测的脑组织饱和度对认知功能的影响。分析了 103 例全身麻醉下接受选择性颈动脉手术的无症状患者的围手术期数据。术前及术后3个月进行MMSE（简易精神状态检查）和MoCA（蒙特利尔认知评估）测试。对于脑监测，使用NIRS，并计算最低rSO ₂值和去饱和度。认知变化被定义为术前测试分数的一个标准差变化，定义为术后神经认知下降（PNCD）和认知改善（POCI）。 PNCD 37 例（35.92%），POCI 18 例（17.47%）。女性、糖尿病患者和去饱和程度与 PNCD 独立相关。交叉钳位期间的去饱和程度与 MoCA 评分的变化呈负相关（ R = − 0.707， p = 0.001）。 15.5% 去饱和率的区分灵敏度为 86.5%，特异性为 78.8%。对于 POCI，低于 12.65% 的去饱和度具有 72.2% 的敏感性和 67.1% 的特异性。 POCI 与较低的术前 MOCA 评分和较低的去饱和度相关。我们发现颈动脉内膜切除术患者术后认知功能的变化与钳夹期间的脑组织饱和度之间存在显着关系，MoCA测试证明了这一变化。