Mehta, Vivek

Honorary Senior Lecturer, Consultant in Pain Medicine

Dr Vivek Mehta did his training at Barts and The London School of Anaesthesia and was appointed Consultant in Pain Medicine at Barts and The London NHS Trust in 2006. He is a full time Pain Consultant with an academic contract. An active researcher, he is also the Deputy Director of The Pain & Anaesthesia Research Centre and currently Principal Investigator in various academic pain studies in neuromodulation. In a short period of time he has established himself as a key opinion leader in this field, and his contributions widely recognised by several national and international invited lectures. His clinical commitments includes out patient consultations, intervention sessions including complex neuromodulation and pain procedures, referrals from palliative care, multidisciplinary pain meetings.

Summary of Research

Pain and Anaesthesia Centre has an international reputation and a long track record in training and supervision in the methodology and conduct of research in basic science and clinical studies. The strong academic links of the pain services at Barts Health bring together a consortium of healthcare professionals with expertise in the delivery of interventional and non-interventional pain medicine, plus research methodologists (complex intervention trial design, medical statistics, health economics).  There is a strong public and patient Involvement with several chartiable organisations including “back care”, “sickle cell society”, “migraine trust”, “migraine action” collaborating in the research projects being conducted by the department. The department has established links and collaborations with the Primary Care Research Networks (PCRNs) and  Central and East London Comprehensive Local Research Network (CLRN) to conduct and clinical trials.

On-going Investigator Initiated Trials (Principal Investigator)

•    The HTA-NIHR programme: (Grant Award £430,000). A pilot multicentre three arm randomised controlled feasibility study (for a definitive trial) of the clinical- and cost-effectiveness of facet joint injections in patients with persistent non-speciic low back pain of more than 6 months' duration.
•    A single centre, randomised, placebo controlled parallel study to investigate the effect of opioids on immunomarkers using gene expression profiling. (Investigator Grant Mundipharma  £365,000).
•    A sham controlled randomised trial to investigate the effects of radiofrequency neurotomy using Simplicity III R on patients with sacro-iliac joint pain. (Investigator Grant Neurotherm $108,000)
•    A prospective open-label pilot study to investigate the changes in peripheral and central sensitization using quantitative sensory testing after percutaneous SCS (including sub-threshold stimulation) in patients with lumbar radiculopathy with FBSS (Investigator Grant Boston Scientific £115,000)
•     Investigation of the ReActiv8 Implantable Stimulation System for Chronic Low Back Pain ReActiv8-A (Investigator Grant Mainstay Medical £14,900)
•    Assessment of burst stimulation in patients undergoing Occipital Nerve Stimulation (Investigator Grant St Jude £41,000)
•    Peripheral Nerve Stimulation Registry For Intractable Migraine Headache: A Prospective, Multi-National Post-Marketing Observational Registry of the Clinical Outcomes of Neuromodulation for the Management of Intractable Chronic Migraine. (Investigator Grant St Jude £14,000)
•    A single centre study to investigate the CSF pharmacokinetics of intravenous administered paracetamol. (Own account)
•    A prospective open label pilot study to investigate whether Quantitative Sensory Testing correlates with the effectiveness of Diagnostic Dorsal Root Ganglion Block and Pulsed Radiofrequency in patients with lumbar radiculopathy. (Own account)
•    Quantitative sensory testing following pregabalin in patients with fibromyalgia. (Own account)
Co investigator:
•    'SCAPE: Sickle Cell Analgesia Pathway Evaluation: Optimising management of the acute painful crisis of sickle cell disease using buccal effervescent fentanyl and oral oxycodone.' (Investigator Grant Barts and The London Charity £206,462)
•    Contribution of opioid modulation to the analgesic effect of Tapentadol: A human volunteer study. (Investigator Grant  Grunenthal £110,000)

Members of the Group

Dr Kristin Ullrich, Dr Saowarat Snidvongs, Dr Theresa Wodehouse, Dr Shankar Ramaswamy, Liam Casey, Dr Serene Chang

Key Publications

Peer reviewed Publications: Original articles, Reviews & Editorials

Mehta V, Langford RM. Acute pain management in opioid dependent patients. Anaesthesia.  2006; 61: 269-76

Langford R M. Mehta V. Selective cyclooxygenase inhibition:  its role in pain and anaesthesia. Biomedicine and Pharmacotherapy. 2006; 7: 323-328

Langford R M, Mehta V Are COX-2 selective inhibitors safe for post-operative pain--Yes and No. International Journal of Acute pain. 2006; 8: 95

Mehta V, Johnston A, Cheung R, Bello A, Langford RM. Intravenous parecoxib rapidly leads to COX-2 inhibitory concentration of valdecoxib in the central nervous system. Clinical Pharmacology & Therapeutics. 2008; 83:430-5

Chang SH, Mehta V, Langford RM. Acute and chronic pain following breast surgery Acute Pain. 2009; 11: 1-14

Mehta V, Langford RM. Acute pain management in opioid dependent patients. Reviews in Pain 2009; 3 (2): 10-14

Mehta V. Peripheral opioid antagonism. Anaesthesia 2009; 64: 1279-83

Mehta V, Shah S. Paracetamol- the forgotten drug. 2010 Br J Hosp Med 71 (11); 606-7

Chang SH, Maney KM, Mehta V, Langford RM. Pain Assessment and Management in Medical Wards: an area of unmet need. Postgrad Med J. 2010 May; 86 (1015): 279-84

Chang SH, Maney KM, Phillips JP, Langford RM, Mehta V. A prospective, randomised, double-blind, placebo-controlled investigation of the respiratory effects of oxycodone versus morphine in anesthetised patients. 2010 65(10): 1007-1012

Kumar P, Nargund V, Mehta V. Chronic testicular pain management-a review. Urol Int. 2010; 84 (2):125-31

Snidvongs S, Mehta V. Pulsed radiofrequency – a non-neurodestructive therapy in pain management. Current Opinion in Palliative & Supportive Care- 2010; 4(2): 107-10

Snidvongs S, Mehta V. Recent advances in opioid prescription for chronic non-cancer pain. Postgrad Med J 2011doi:10.1136/pgmj.2010.112045

Shah S, Mehta V. Controversies and advances in non-steroidal anti-inflammatory drug analgesia in chronic pain management. Postgrad Med J 2011 doi. 10.1136/postgradmedj-2011-130291

Randive S, Mehta V. Breakthrough pain- novel analgesics. Current Clinical Pharmacology. 2012 May;7(2):116-20

Husband M, Mehta V Cyclo-oxygenase-2 inhibitors . Continuing Education in Anaesthesia, Critical Care & Pain 2013; doi: 10.1093/bjaceaccp/mkt004

Chhaya V Sharma; Vivek Mehta Paracetamol: mechanisms and updates 
 
Continuing Education in Anaesthesia, Critical Care & Pain 2013; doi: 10.1093/bjaceaccp/mkt049

Mehta V, Alawad S, Kuravinakop S, Nikolic S,. Effect of a Fixed-Dose Opioid Agonist/Antagonist on Constipation in Patients on Long-term Opioids for Non-Malignant Pain Unable to Tolerate Laxatives. Pain Physician 2014; 17:415-424

Ramaswamy S, Chang S, Mehta V. Tapentadol Evidence So far. Anaesthesia 2015,70,518-9

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