Ropivacaine
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Ropivacaine
Brand names: Naropin®
Chemical formula:
- Espa�ol:
- Inyección de ropivacaína
Ropivacaine injection
What is ropivacaine injection (Naropin®)?
ROPIVACAINE (Naropin®) is a drug that is injected before and during various surgical procedures or during labor and delivery. Ropivacaine is an anesthethic, and causes loss of feeling in the skin and surrounding tissues. Generic ropivacaine injection is not available.What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:• heart or blood vessel disease
• liver disease
• myasthenia gravis
• any unusual of allergic reaction to ropivacaine, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding
How should I use this medicine?
Ropivacaine is injected into a specific area to make it numb before surgery or other procedure. Depending on the type of procedure it may be given into the area around your spine or into other areas so you will not feel pain during the procedure. Only a specially trained health-care professional will give ropivacaine in a hospital or clinic.What if I miss a dose?
This does not apply.What drug(s) may interact with ropivacaine?
• cimetidine• fluvoxamine
• imipramine
• theophylline
Tell your prescriber or health care professional about all other medicines that you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also, tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.
What should I watch for while taking ropivacaine?
Let your prescriber or health care professional know if the feeling of numbness that ropivacaine causes does not wear off within a few hours, or if you find it hard to open your mouth.After an injection of ropivacaine the area will be numb for some time and you will not be aware of pain. Try to avoid injury to the area.
What side effects may I notice from taking ropivacaine?
Side effects that you should report to your prescriber or health care professional as soon as possible:• anxiety, restlessness
• blurred vision
• difficulty breathing
• dizziness, drowsiness
• irregular heartbeat (palpitations)
• metallic taste
• nausea, vomiting
• ringing of the ears
• seizures (convulsions)
• skin rash, itching (hives)
• swelling of the face or mouth
• tremors
• twitching
If they are going to occur, these side effects may become apparent before you leave the hospital, clinic or dental office. Call your health care provider as soon as you can if you get any of the above reactions later.
Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
• light-headedness
• numbness or tingling of the face or mouth
• pain at the injection site
Where can I keep my medicine?
You will only receive ropivacaine in a hospital or clinic setting prior to surgery or other procedures. You will not need to take this medicine at home.Last updated: 7/1/2002
Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.
Saunders Veterinary Dictionary:
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ropivacaine
A long-acting aminoamide local anesthetic agent, similar to bupivacaine.
Wikipedia on Answers.com:
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Ropivacaine
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| Systematic (IUPAC) name | |
| (S)-N-(2,6-dimethylphenyl)- 1-propylpiperidine-2-carboxamide |
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| Clinical data | |
| AHFS/Drugs.com | Consumer Drug Information |
| Pregnancy cat. | B1 (AU) |
| Legal status | Prescription Only (S4) (AU) |
| Routes | Parenteral |
| Pharmacokinetic data | |
| Bioavailability | 87%–98% (epidural) |
| Metabolism | Hepatic (CYP1A2-mediated) |
| Half-life | 1.6–6 hours (varies with administration route) |
| Excretion | Renal 86% |
| Identifiers | |
| CAS number | 84057-95-4  |
| ATC code | N01BB09 |
| PubChem | CID 175805 |
| DrugBank | DB00296 |
| ChemSpider | 153165 |
| UNII | 7IO5LYA57N |
| KEGG | D08490 |
| ChEBI | CHEBI:8890 |
| ChEMBL | CHEMBL1077896 |
| Chemical data | |
| Formula | C17H26N2O |
| Mol. mass | 274.4 g/mol |
| SMILES | eMolecules & PubChem |
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Ropivacaine (rINN) (
/roʊˈpɪvəkeɪn/) is a local anaesthetic drug belonging to the amino amide group. The name ropivacaine refers to both the racemate and the marketed S-enantiomer. Ropivacaine hydrochloride is commonly marketed by AstraZeneca under the trade name Naropin.
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Contents
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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
Indications
Ropivacaine is indicated for local anaesthesia including infiltration, nerve block, epidural and intrathecal anaesthesia in adults and children over 12 years. It is also indicated for peripheral nerve block and caudal epidural in children 1–12 years for surgical pain. It is also sometimes used for infiltration anaesthesia for surgical pain in children.
Ropivacaine is often co-administered with fentanyl for epidural analgesia, for example in pregnant women during labour.
Contraindications
Ropivacaine is contraindicated for IV regional anaesthesia (IVRA). However, new data suggested that both Ropivacaine (1.2-1.8mg/kg in 40ml) and levobupivacaine (40ml of 0.125% solution) can be used, because they have less cardiovascular and central nervous system toxicity than racemic bupivacaine (Basic of Anesthesia, Robert Stoelting, page 289).
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 central nervous system (CNS) and cardiovascular effects – CNS effects usually occur at lower blood plasma concentrations and additional cardiovascular effects present at higher concentrations, though cardiovascular collapse may also occur with low concentrations. CNS effects may include CNS excitation (nervousness, tingling around the mouth, tinnitus, tremor, dizziness, blurred vision, seizures) followed by depression (drowsiness, loss of consciousness, respiratory depression and apnea). Cardiovascular effects include hypotension, bradycardia, arrhythmias, and/or cardiac arrest – some of which may be due to hypoxemia secondary to respiratory depression.[1]
Treatment of overdose: "Lipid rescue"
As for bupivacaine, there is evidence that Celepid, a commonly available intravenous lipid emulsion, can be effective in treating severe cardiotoxicity secondary to local anaesthetic overdose in animal experiments[2] and in humans.[3][4][5]
References
- ^ Rossi S, editor. Australian Medicines Handbook 2006. Adelaide: Australian Medicines Handbook; 2006. ISBN 0-9757919-2-3
- ^ Weinberg, G, Ripper, R, Feinstein, DL, Hoffman W. Lipid emulsion infusion rescues dogs from bupivacaine-induced cardiac toxicity. Reg Anesth Pain Med 2003;28:198-202. doi:10.1053/rapm.2003.50041 PMID 12772136
- ^ Picard J, Meek T. Lipid emulsion to treat overdose of local anaesthetic: the gift of the glob. Anaesthesia 2006;61:107-9. doi:10.1111/j.1365-2044.2005.04494.x PMID 16430560
- ^ Rosenblatt MA, Abel M, Fischer GW, Itzkovich CJ, Eisenkraft JB. Successful Use of a 20% lipid emulsion to resuscitate a patient after a presumed bupivacaine-related cardiac arrest. Anesthesiology 2006;105:217-8. doi:10.1097/00000542-200607000-00033 PMID 16810015
- ^ Litz, RJ, Popp M, Stehr S N, Koch T. Successful resuscitation of a patient with ropivacaine-induced asystole after axillary plexus block using lipid infusion. Anaesthesia 2006;61:800-1.
External links
- European Society of Anaesthesiologists: Use of ropivacaine in clinical practice
- More on lipid rescue
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Copyrights:
Saunders Veterinary Dictionary
Saunders Comprehensive Veterinary Dictionary 3rd Edition. Copyright © 2007 by D.C. Blood, V.P. Studdert and C.C. Gay, Elsevier. All rights reserved.
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