The study evaluated the effect of low-dose sevoflurane conditioning on early postoperative cognitive function in patients aged 50–80 years undergoing carotid endarterectomy (CEA). A total of 71 patients were randomized into two groups: one receiving sevoflurane post-conditioning, the other propofol (group P, n = 35). Cognitive function was measured using the MMSE and MoCA tests before surgery and on postoperative days 1 and 3. Results showed that the propofol group had a significant decline in cognitive scores on postoperative day 1 (MMSE -0.97 ± 1.81; MoCA -0.80 ± 1.83), while the sevoflurane group maintained or slightly improved cognitive scores (MMSE +0.58 ± 1.76; MoCA +0.81 ± 2.59). This difference between groups was statistically significant on both postoperative day 1 and 3 (MMSE p = 0.002 and 0.023; MoCA p = 0.037 and 0.036). The study thus suggests a potential neuroprotective role of sevoflurane after conditioning in patients after CEA. Further research is needed to examine the long-term effects and biological mechanisms[article].