Postoperative confusion preceded by decreased frontal lobe haemoglobin oxygen saturation

We describe a 58-year-old male patient with confusion and prolonged recover y after liver transplantation. A cause was not apparent for the confusion, but during surgery, monitoring of the frontal lobe cerebral haemoglobin oxy gen saturation by near-infrared spectrophotometry showed cerebral hyp-oxyge nation despite optimization of conventional cardiovascular parameters. It i s possible that intraoperative cerebral ischaemia is the cause of post-surg ical confusion and with near-infrared spectrophotometry this hypothesis may be tested clinically.