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This specific combination therapy is being evaluated in a Phase 1 clinical trial (NCT04445337) led by the University of Nebraska Medical Center for the treatment of COVID-19-associated acute respiratory distress syndrome (ARDS). The intervention involves a modified stellate ganglion block (SGB) using a combination of the local anesthetic bupivacaine, the alpha-2 adrenergic agonist clonidine, and the synthetic corticosteroid dexamethasone (specifically the preservative-free formulation Decadron PF). This regional nerve blockade approach aims to modulate sympathetic nervous system hyperactivity and reduce systemic inflammation (cytokine storm) associated with severe COVID-19. Dexamethasone is included in the mixture to provide direct anti-inflammatory effects on the stellate ganglia and to prolong the duration of the block, while clonidine and bupivacaine work synergistically to inhibit sympathetic outflow and interrupt nerve conduction.
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