Ropivacaine

Source: Wikipedia, the free encyclopedia.
Ropivacaine
Clinical data
Trade namesNaropin, Rocaine
AHFS/Drugs.comMonograph
Pregnancy
category
  • AU: B1
Parenteral
ATC code
Legal status
Legal status
  • AU: S4 (Prescription only)
Pharmacokinetic data
Bioavailability87%–98% (epidural)
MetabolismLiver (CYP1A2-mediated)
Elimination half-life1.6–6 hours (varies with administration route)
ExcretionKidney 86%
Identifiers
  • (S)-N-(2,6-dimethylphenyl)-
    1-propylpiperidine-2-carboxamide
JSmol)
Melting point144 to 146 °C (291 to 295 °F)
  • O=C(Nc1c(cccc1C)C)[C@H]2N(CCC)CCCC2
  • InChI=1S/C17H26N2O/c1-4-11-19-12-6-5-10-15(19)17(20)18-16-13(2)8-7-9-14(16)3/h7-9,15H,4-6,10-12H2,1-3H3,(H,18,20)/t15-/m0/s1 checkY
  • Key:ZKMNUMMKYBVTFN-HNNXBMFYSA-N checkY
  (verify)

Ropivacaine (

racemate and the marketed S-enantiomer. Ropivacaine hydrochloride is commonly marketed by AstraZeneca
under the brand name Naropin.

History

Ropivacaine was developed after bupivacaine was noted to be associated with cardiac arrest, particularly in pregnant women. Ropivacaine was found to have less cardiotoxicity than bupivacaine in animal models.

Clinical use

Contraindications

Ropivacaine is contraindicated for

intravenous regional anaesthesia (IVRA). However, new data suggested both ropivacaine (1.2-1.8 mg/kg in 40ml) and levobupivacaine (40 ml of 0.125% solution) can be used, because they have less cardiovascular and central nervous system toxicity than racemic bupivacaine.[1]

Adverse effects

Adverse drug reactions (ADRs) are rare when it is administered correctly. Most ADRs relate to administration technique (resulting in systemic exposure) or pharmacological effects of anesthesia, however allergic reactions can rarely occur.

Systemic exposure to excessive quantities of ropivacaine mainly result in

hypoxemia secondary to respiratory depression.[2]

Postarthroscopic glenohumeral chondrolysis

Ropivacaine is toxic to cartilage and their intra-articular infusions can lead to Postarthroscopic glenohumeral chondrolysis.[3]

Treatment of overdose

As for

lipid rescue.[5][6][7]

References

  1. ^ (Basic of Anesthesia, Robert Stoelting, page 289)
  2. ISBN 0-9757919-2-3
  3. PMID 27047224
    .
  4. S2CID 6247454
    .
  5. S2CID 29843241
    .
  6. S2CID 40214528
    .
  7. S2CID 43125067
    .

External links
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