HEs Consciousness Scale: a rapid and promising classification for early assessment of post-anesthesia consciousness recovery.

Postoperative cognitive dysfunction (POCD) is a common complication after thoracic surgery, especially after complex surgeries involving general anesthesia, such as lung transplantation. Improving anesthetic strategies may offer an effective approach to reducing the incidence of POCD. Non-intubated anesthesia has emerged as a transformative advancement in thoracic surgery and anesthesia. The approach combines regional anesthesia with minimal sedation and avoids muscle relaxants, potentially mitigating neurocognitive impairment. Additionally, early detection is crucial for timely intervention and contributes to postoperative outcomes. Although various classification systems have been proposed to assess cognitive function following anesthesia and surgery, their complexity and the need for multidisciplinary often limit their applicability and efficiency. To address these challenges, we developed the HEs Consciousness. We retrospectively review 172 patients, including 72 patients received lung transplantation and 100 patients underwent general thoracic surgery. The HEs scale was used to assess cognitive status within hours after surgery. Patients classified as grade I-II received timely interventions, which effectively prevented progression to POCD. Preliminary findings suggested that this scale is a promising and practical tool for the early detection of cognitive dysfunction. The HEs Consciousness Scale offers a simplified, rapid, and structured approach to postoperative cognitive evaluation, making it well-suited for integration into routine perioperative care. Its broader applicability requires further validation to establish its reliability and generalizability across diverse clinical settings.