use strict;
my $str = '- Dios mÃo, ¡está aquÃ, está aquÃ!
- ¿Qué paso, qué paso?
- Me rehúso, me rehúso.';
my $regex = qr/(?i)(\b|[¡¿])(?<uno>[^\s]+\s[^,]+),\s(\k<uno>)([?!]|\b)/mp;
my $subst = '$1$2$4';
my $result = $str =~ s/$regex/$subst/rg;
print "The result of the substitution is' $result\n";
Please keep in mind that these code samples are automatically generated and are not guaranteed to work. If you find any syntax errors, feel free to submit a bug report. For a full regex reference for Perl, please visit: http://perldoc.perl.org/perlre.html