Perioperative Brain Health Centre


A custom surgical simulator is shown that was used to determine appropriate freehand techniques of cortical screw insertion in the thoracic and lumbar spine.

Pre-clinical research


Pre-clinical research is performed in the laboratory for mechanisms of anesthesia located in the department of physiology, University of Toronto. The team is led by Dr. Beverley Orser, scientist & professor in the department of anesthesia and physiology, and chair of the department of anesthesia, University of Toronto.

Pre-clinical studies

The discovery of general anesthesia is one of the greatest advances in the history of medicine. However, the molecular mechanisms of how anesthetics work have eluded scientists for centuries. This lack of understanding has stalled drug development and contributes to an inability to treat anesthesia-related disorders. The main goal of the laboratory is to understand the molecular mechanisms of general anesthetics and discover new therapeutic drugs to improve patient care.

Clinical research



Dr. Stephen Choi
Clinical Research Officer

Research Partners

Dr. Sinziana Avramescu
Humber River Hospital

Dr. George N. Djaiani

Dr. Nathan Herrmann
Dept of psychiatry

Dr. Philip Jones
LHSC University Hospital

Dr. Alex Kiss
Dept of health policy, management and evaluation

We thank Cogstate for generous in-kind donation of online cognitive assessment tool

Senior Friendly

Dr. Krista Lanctôt
Depts of psychiatry and pharmacology & toxicology

Dr. David Mazer
Dept of anesthesia (SMH)

Dr. Tarit Saha
KGH Research Institute

Kevin Thorpe
Dalla Lana School of Public Health

Dr. Summer Syed
Hamilton General Hospital, McMaster University

Dr. Angela Jerath
Sunnybrook Health Sciences Centre, University of Toronto

Research team

Dr. Lilia Kaustov
Director of operations
Research Manager

Dr. Andrew Fleet
Research Coordinator

Boris Yakubov
Research Coordinator

Yashvi Verma
Research Assistant

Amara Singh
Graduate student

Elizabeth Lappin
Research Assistant

Connor Brenna
Research Fellow

Clinical trials

Investigator initiated

Cognitive Changes After Major Joint Replacement - Full Trial (NCT03147937)

Based on our pilot study, we are currently recruiting a total of 600 patients to assess for cognitive changes after major joint replacement.

Dexmedetomidine to reduce the incidence of persistent cognitive dysfunction after open cardiac surgery - Multicentre Trial (NCT04289142)

Anesthesia is a drug induced reversible, comatose state that facilitates surgery. While it is widely assumed that cognition returns to baseline after anesthetics have been eliminated, many patients have persistent memory impairment for weeks to months after surgery. These cognitive deficits, termed postoperative cognitive dysfunction (POCD), are associated with significant negative health and social implications. There are no existing preventative or treatment strategies.

POCD has been reported in patients undergoing anesthetia associated with all types of surgeries, while cardiac surgeries appear to carry the highest risk. Notably, up to 80% of patients have POCD 3 weeks after cardiac surgery and up to 60% have persistent POCD at 6 months.

In this clinical trial we investigate the role of the Precedex (Dexmedetomidine) in preventing POCD up to three months after cardiac surgery and enhancing early postoperative recovery. Precedex is a drug that is used in clinical practice as a sedative and analgesic. The results of this trial will provide an insight on the efficacy of Precedex in reducing the incidence of POCD after anesthesia, and may lead to identification the first POCD preventative therapeutics.


PODESA (NCT02954224)

Delirium is a common complication in elderly patients following surgery. Patients who develop delirium after surgery are at increased risk for serious complications, and even death. This multi-centre randomized controlled trial will enroll elderly patients scheduled for elective hip/knee replacement surgery. The objective of this trial is to identify obstructive sleep apnea using ApneaLink Air and to determine whether auto-titrating CPAP treatment of obstructive sleep apnea will decrease the incidence of post-operative delirium in elderly patients undergoing elective hip and knee replacement surgery.

REGAIN (NCT02507505)

Spinal and general anesthesia represent the two standard care approaches to anesthesia for hip fracture surgery. Basic and clinical research has identified multiple plausible mechanisms by which spinal anesthesia may improve outcomes after hip fracture, such as delirium; nonetheless, major guidelines and systematic reviews have identified key evidence gaps and anesthesia care for hip fracture varies markedly in practice. REGAIN is the first pragmatic multicenter prospective randomized trial of spinal versus general anesthesia for hip fracture surgery designed to evaluate the association of anesthesia technique with functional recovery after hip fracture.

Select Publications from our Centre

Patients are critical to the success of our research. Read more »