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Bupivacaine + fibrin sealant is an investigational combination therapy developed by the Indiana University School of Medicine for the management of postoperative pain and hemorrhage following pediatric tonsillectomy or adenotonsillectomy. The therapy involves infusing bupivacaine, a long-acting local anesthetic of the amide type, into a fibrin sealant matrix. Bupivacaine functions by blocking voltage-gated sodium channels in nerve fibers, thereby inhibiting the influx of sodium ions and preventing the initiation and conduction of pain impulses. The fibrin sealant, typically composed of fibrinogen and thrombin, acts as a hemostatic agent to reduce bleeding and serves as a delivery vehicle for the sustained release of bupivacaine directly at the surgical site.
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