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This combination therapy involves the addition of dexamethasone, a synthetic glucocorticoid, to bupivacaine, a long-acting amide-type local anesthetic, for use in regional nerve blocks. Specifically investigated by Temple University in a Phase 2 clinical trial (NCT04919317), the mixture is administered as a modified Pecs II (pectoral nerve) block to manage postoperative pain in patients undergoing bilateral reduction mammaplasty. Bupivacaine provides regional anesthesia by blocking voltage-gated sodium channels, while dexamethasone is hypothesized to prolong the analgesic effect through the inhibition of nociceptive C-fibers, upregulation of inhibitory potassium channels, and induction of regional vasoconstriction. The primary clinical objective of this combination is to enhance the duration of postoperative analgesia and significantly reduce the requirement for inpatient opioid consumption following breast surgery.
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