Desflurane combined with ciprofol or esketamine improves postoperative symptoms without compromising early neurocognitive recovery after intracranial aneurysm endovascular coiling.

The Montreal Cognitive Assessment scores improved significantly over time across all groups ( p < 0.001), with no significant differences in neurocognitive recovery trajectories among groups (interaction effect, p = 0.196; group effect, p = 0.729).

The DC group also exhibited the lowest incidence of dizziness (8.8%) and the lowest metoclopramide requirement ( p = 0.012).

Postoperative pain scores were significantly lower in the DE group than in the DC group (adjusted p = 0.026).