Classes
DEA Class; Rx
Common Brand Names; Naropin
- Local Anesthetics, Amides;
- Local Anesthetics, Parenteral
Description
Long-acting, amide-type local anesthetic; structure and kinetics are similar to bupivacaine, however, ropivacaine appears to be less arrhythmogenic.
Indications
Indicated for local anesthesia, regional anesthesia, or surgical anesthesia.
Contraindications
Hypersensitivity to ropivacaine or amide-type local anesthetics, sensitivity to parabens
Adverse Effects
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)
Warnings
Use caution in patients with 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
Addition of vasoconstrictor, epinephrine, will promote local hemostasis, decrease systemic absorption, and increase duration of action
Seizures reported with systemic toxicity
This drug should be used with caution in patients receiving other local anesthetics or agents structurally related to amide-type local anesthetics since the toxic effects of these drugs are additive
Patients treated with class III antiarrhythmic drugs (eg, amiodarone) should be under close surveillance and ECG monitoring considered, since cardiac effects may be additive
The plasma concentrations of this drug may approach threshold for central nervous system toxicity after administration of 300 mg of ropivacaine for brachial plexus block; exercise caution when using 300 mg dose; the dose for a major nerve block must be adjusted according to site of administration and patient status; supraclavicular brachial plexus blocks may be associated with a higher frequency of serious adverse reactions, regardless of local anesthetic used
Major peripheral nerve blocks may result in administration of a large volume of local anesthetic in highly vascularized areas, often close to large vessels where there is increased risk of intravascular injection and/or rapid systemic absorption, which can lead to high plasma concentrations
The use of this drug in retrobulbar blocks for ophthalmic surgery has not been studied; until appropriate experience gained, the use for such surgery is not recommended
Pregnancy and Lactation
There are no adequate or well-controlled studies in pregnant women of effects of this drug on developing fetus; this drug should only be used during pregnancy if the benefits outweigh risk
One publication reported that ropivacaine is present in human milk at low levels following administration in women undergoing cesarean section; no adverse reactions were reported in the infants
Maximum Dosage
The dose of local anesthetics differs with the anesthetic procedure; the area to be anesthetized; the vascularity of the tissues; the number of neuronal segments to be blocked; the intensity of the block; the degree of muscle relaxation required; the duration of anesthesia desired; individual tolerance; and the physical condition of the patient.
The maximum dosage is dependent on route of administration and indication for therapy.
The maximum dosage is dependent on route of administration and indication for therapy.
Safety and efficacy have not been established.
Safety and efficacy have not been established; 2.5 mg/kg using a 0.25% solution has been used for caudal anesthesia.
How supplied
Ropivacaine Hydrochloride
injectable solution
- 2mg/mL
- 5mg/mL
- 7.5mg/mL
- 10mg/mL