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B-DEX-MPA is an investigational triple-combination therapy developed by Yale University for the management of post-surgical pain, specifically in patients undergoing total knee arthroplasty (TKA). It consists of the local anesthetic bupivacaine and two corticosteroids: the fast-acting, water-soluble dexamethasone sodium phosphate and the long-acting, depot-formulated methylprednisolone acetate. The combination is administered via peripheral nerve blocks, such as the adductor canal block and iPACK block. Bupivacaine provides immediate analgesia by blocking voltage-gated sodium channels, while the corticosteroids are intended to prolong the duration of the block and reduce local inflammation. This formulation is being evaluated in Phase 2 clinical trials (the Yale SEVEN studies) to compare its efficacy and duration of pain relief against liposomal bupivacaine (Exparel).
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