Ropivacaine

Indications

Ropivacaine is used for: Local Anesthesia

Adult Dose

Epidural/Caudal Anesthesia 75-200 mg (15-30 mL of 0.5%-1% solution) Major Nerve Block 175-250 mg (35-50 mL) of 0.5% solution 75-300 mg (10-40 mL) of 0.75% solution Field Block 5-200 mg (1-40 mL) of 0.5% solution Labor Pain 20-40 mg (10-20 mL) initial of 0.2% solution, THEN 12-28 mg/hr (6-14 mL/hr) of 0.2% solution OR 20-30 mg/hr (10-15 mL/hr) continuous infusion of 0.2% solution Post-Op Pain Peripheral Nerve Block 5-10 mL/hr continuous infusion of 0.2% solution Lumbar or Thoracic Epidural 6-14 mL/hr continuous infusion of 0.2% solution Infiltration/ Minor Nerve Block 1-100 mL dose of 0.2% solution 1-40 mL dose of 0.5% solution

Child Dose

Renal Dose

Administration

Contra Indications

Hypersensitivity to ropivacaine or amide-type local anesthetics, sensitivity to parabens Obstetrical paracervical block anesthesia

Precautions

History of malignant hyperthermia DO NOT use solutions with epinephrine in distal areas of body (eg, digit, nose, ear) Use preservative-free preparations for spinal or epidural anesthesia Monitor patient's state of consciousness following the injection; anxiety, dizziness, restlessness, tremors, depression, or blurred vision may be signs of CNS toxicity Addition of vasoconstrictor, epinephrine, will promote local hemostasis, decrease systemic absorption, and increase duration of action Respiratory arrest reported with use Seizures reported with systemic toxicity

Pregnancy-Lactation

Pregnancy Category: C Lactation: not known if excreted in breast milk

Interactions

Adverse Effects

Side effects of Ropivacaine : Frequency Not Defined Bradycardia, myocardial depression, , cardiac arrhythmias, edema, hypotension, cardiovascular collapse, cardiac arrest, palpitation, tachycardia, anginal pain, hypertension (epinephrine-containing solutions) Anxiety, apprehension, chills, headache, restlessness, nervousness, disorientation, confusion, dizziness, tremors, twitching, shivering, seizures; CNS depression manifested restlessness, tremors, drowsiness, unconsciousness, tinnitus Nausea, vomiting Blurred vision, miosis Respiratory arrest, status asthmaticus Anaphylactoid reactions (sometimes fatal)

Mechanism of Action

Local anesthetics prevent generation/conduction of nerve impulses by reducing sodium permeability & increasing action potential threshold