Correlation analysis of postoperative cognitive function and event-related potentials in patients undergoing general anesthesia

Background: As the population ages, both the proportion of elderly surgical patients and the incidence of postoperative delirium (POD) are rising. Due to the challenges in identifying POD, misdiagnosis and missed diagnosis remain common, highlighting the need for objective cognitive assessment tools. Objective: To compare event-related potentials (ERPs) characteristics between patients with and without POD following general anesthesia, and to evaluate the potential of ERPs as predictive diagnostic markers for POD. Methods: POD was assessed in 28 patients with gastrointestinal tumors using the 3D-CAM scale on postoperative days 1, 3, and 7 Task-related electroencephalograms (EEGs) were recorded using a 64-channel system approximately 10 days after surgery. ERP components P300 and N200, along with task accuracy, were analyzed to evaluate electrophysiological changes associated with POD. Results: P300 and N200 latencies were significantly prolonged and amplitudes reduced in patients with delirium. ROC curve analysis revealed strong diagnostic efficacy of ERP latency parameters in identifying POD. Conclusions: Patients with postoperative delirium demonstrated significant alterations in event-related potentials, particularly prolonged P300 and N200 latencies and a trend toward reduced amplitudes. These findings suggest that P300 and N200 may serve as promising, non-invasive electrophysiological markers for the detection of delirium; however, further studies with larger sample sizes and longitudinal designs are needed to validate their diagnostic utility.