This Is Your Brain After Anesthetic: Dr. Peter Hedlin

Описание: Peter Hedlin (PhD, MD) recalls being a 'young, naïve medical student' when he asked a mentor a question that's stuck with him for years.


"I remember asking how anaesthetics work on the brain," said Hedlin. "And he said, 'we actually don't really know'. And I thought that was crazy."





Today, Hedlin is an anesthesiologist and clinician scientist (https://scholar.google.com/citations?...) at the University of Saskatchewan's College of Medicine. He examines what surgery and sedation do to the human body — in particular, to aging brains.


Trained first as a microbiologist who earned his PhD as a vaccine researcher at VIDO (Vaccine and Infections Disease Organization) (https://www.vido.org/index.php) , Hedlin was always drawn to medicine. He gravitated toward helping patients one-on-one, and loved the immediate feedback of operating‑room decisions.


"I love to see immediate consequences of actions and anesthesia's perfect for that," he said. "Some people hate being in hospitals, but I love it."





In this episode, Hedlin unpacks post‑operative delirium: the "loopiness" many people feel a day or two after surgery. Most of the grogginess eventually wears off, but for those over age 60, it can persist.


In older adults, cognitive dysfunction may appear as visible agitation, as patients hallucinate or pull out intravenous lines following surgery. Conversely, it can be easier to miss when patients enter a quieter, hypoactive state, withdrawing and not talking as much.





That 'acute brain failure' can last weeks, months, even years. It's linked to longer hospital stays, higher short‑term mortality and a greater chance of ending up in long‑term care.


"We don't have a great understanding why that happens," said Hedlin. "I'd love to make care for our elderly patients better, and we know cognitive dysfunction in the surgical period is common."





Hedlin says that work begins before long the patient's surgery date. Along with nursing managers, psychiatric and geriatric specialists, he's piloting a screening tool to assess older patients (https://www.shrf.ca/post/2023-24-solu...) for frailty and cognitive risk. He asks patients to bring along a friend or a family member, who knows their baseline, to assist with daily delirium checks before and after the operation.


"When we can identify these patients several weeks before their surgery, then it gives potentially an opportunity to intervene and optimise that patient prior to their their surgical event," he said.


Hedlin is also participating in (https://pmc.ncbi.nlm.nih.gov/articles...) larger, randomized studies (https://webapps.cihr-irsc.gc.ca/decis...) , and is watching developments in other parts of the country (https://jamanetwork.com/journals/jama...) with interest.





But Hedlin also points to simple fixes hospital staff can make, such as returning patients' hearing aids and glasses, and ensuring older patients get a good night's sleep after surgery.


"Just returning people to as normal a situation as possible is really quite helpful for reorienting them in that post-operative period," he said.