Vishvarani Wanigasekera

My research focus is on understanding how analgesics modulate neural activity that underlies nociception and pain perception to ultimately optimize pain relief in chronic pain patients.

Chronic pain is poorly managed, lack of effective analgesics being a key reason. Even opioids, one of the most powerful analgesics that are available for treating moderate to severe pain, has a mixed success rates in treating chronic pain. The amount of analgesia patients experience is variable and inconsistent with some patients developing tolerance, heightened pain sensitivity and even dependence and misuse.

Inherent variability in subjective pain reports and the expectation driven effects on pain reports make assessment of analgesics efficacy challenging especially during analgesic drug development.

Using functional neuroimaging I study the analgesic modulation of neural mechanisms that underpin nociception, central sensitisation and pain processing. I work with a range of analgesics including the intravenous opioid remifentanil. My work is targeted at improving early analgesic drug development processes by using mechanism based disease models to demonstrate analgesic modulation of the pain and nociception related neural activity. My work also aims to understand the neurological basis of expectation related effects in a double-blind randomised randomised clinical trial setting. My interests also extend to understanding the how prior experience of aversive perceptions in patients impact therapeutic interventions. 

I am also a practicing clinician at the Oxford University Hospitals Trust with clinical commitments as an intensivist in the Cardio Thoracic Critical Care Unit at the John Radcliffe Hospital. As a practicing anaesthetist, I am interested in identifying predictors of opioid analgesic efficacy and susceptibility to the development of tolerance and hyperalgesia in chronic pain patients aiming to help personalize analgesic therapy in this population of patients.