Products
Ropivacaine is commercially available as a solution for injection (Naropin, generic). It has been approved in many countries since 1997.
Structure and properties
Ropivacaine (C17H26N2O, Mr = 274.4 g/mol) is present in drugs as ropivacaine hydrochloride monohydrate. It was developed as a pure -enantiomer and belongs to the lipophilic amide-type local anesthetics. Ropivacaine is structurally closely related to bupivacaine or levobupivacaine.
Effects
Ropivacaine (ATC N01BB09) has local anesthetic and analgesic properties. The effects are due to reversible blockade of conduction along nerve fibers by inhibition of sodium ion current into nerve cells. Ropivacaine is one of the long-acting local anesthetics.
Indications
Ropivacaine is used in anesthesia and for pain management:
- Epidural anesthesia for surgical procedures, including cesarean section.
- Plexus blocks
- Conduction and infiltration anesthesia
Dosage
According to the SmPC. Ropivacaine is administered epidurally or injected locally. It must not be administered intravascularly (into blood vessels)!
Contraindications
- Hypersensitivity, including to related amide-type local anesthetics.
- Shock conditions
- Infection of the injection site
For complete precautions, see the drug label.
Interactions
Ropivacaine is metabolized by CYP1A2 and CYP3A4. Drug-drug interactions have been described with local anesthetics, antiarrhythmics, narcotics, opioids, and CYP1A2 inhibitors such as fluvoxamine and enoxacin.
Adverse effects
The most common potential adverse effects include low blood pressure, nausea, and vomiting.