Download - Ropivacaine
![Page 1: Ropivacaine](https://reader036.vdocuments.pub/reader036/viewer/2022092623/58716eed1a28ab58758b7195/html5/thumbnails/1.jpg)
ROPIVACAINEVerdah SabihHouse officerAnesthesiology dept. HFH
![Page 2: Ropivacaine](https://reader036.vdocuments.pub/reader036/viewer/2022092623/58716eed1a28ab58758b7195/html5/thumbnails/2.jpg)
INTRODUCTION: Long acting amide local anesthetic with both
anesthetic and analgesic effects. Similar to bupivacaine & etidocaine in
duration of activity. Structurally similar to mapivacaine &
bupivacaine. Decreased cardiotoxicity Used for regional nerve block. At high doses it produces surgical anesthesia
and at lower doses it produces analgesia (sensory block) with limited motor block..
![Page 3: Ropivacaine](https://reader036.vdocuments.pub/reader036/viewer/2022092623/58716eed1a28ab58758b7195/html5/thumbnails/3.jpg)
STRUCTURE: belongs to the group of
local anaesthetics, the pipecoloxylidides and has a propyl group on the piperidine nitrogen atom (compared to bupivacaine, which has a butyl group)
Enantiomer of propivacaine (S stereoisomer)
![Page 4: Ropivacaine](https://reader036.vdocuments.pub/reader036/viewer/2022092623/58716eed1a28ab58758b7195/html5/thumbnails/4.jpg)
PHARMACOKINETICS Onset time : 15 mins Duration :2-6 hrs Bioavailability:87%–98% (epidural) Metabolism: Hepatic (CYP1A2-mediated) Biological half-life:1.6–6 hours (varies with
administration route) Excretion: Renal 86% less lipophilic than bupivacaine less likely to
penetrate large myelinated motor fibres selective action on the pain-transmitting A β and C nerves rather than Aβ fibres, which are involved in motor function.
bound to plasma proteins to an extent of 94%, mainly to α1-acid glycoprotein.
![Page 5: Ropivacaine](https://reader036.vdocuments.pub/reader036/viewer/2022092623/58716eed1a28ab58758b7195/html5/thumbnails/5.jpg)
MODE OF ACTION reversible inhibition of sodium ion influx, and
thereby blocks impulse conduction in nerve fibre.
potentiated by dose-dependent inhibition of potassium channels.
![Page 6: Ropivacaine](https://reader036.vdocuments.pub/reader036/viewer/2022092623/58716eed1a28ab58758b7195/html5/thumbnails/6.jpg)
DOSAGE AND ADMINISTRATION Max.dose= 3mg/kg
TECHNIQUES: Epidural block Spinal block Infiltration anesthesia Peripheral nerve block
![Page 7: Ropivacaine](https://reader036.vdocuments.pub/reader036/viewer/2022092623/58716eed1a28ab58758b7195/html5/thumbnails/7.jpg)
INDICATIONS Local Surgical anesthesia C-section Hip or lower limb surgery Peripheral nerve blocks Post operative pain management Labour pain management Chronic pain management
![Page 8: Ropivacaine](https://reader036.vdocuments.pub/reader036/viewer/2022092623/58716eed1a28ab58758b7195/html5/thumbnails/8.jpg)
CONTRAINDICATIONS Use as intravenous regional anaesthesia
(IVRA).
![Page 9: Ropivacaine](https://reader036.vdocuments.pub/reader036/viewer/2022092623/58716eed1a28ab58758b7195/html5/thumbnails/9.jpg)
CLINICAL SIDE EFFECTS CNS toxicity:usually occur at lower blood
plasma concentrations CNS excitation,(nervousness, tingling around
the mouth, tinnitus,tremor, dizziness, blurred vision, seizures) followed by depression(drowsiness, loss of consciousness), respiratory depression and apnea).
CVS toxicity: hypotension, bradycardia, arrhythmias,
and/or cardiac arrest
![Page 10: Ropivacaine](https://reader036.vdocuments.pub/reader036/viewer/2022092623/58716eed1a28ab58758b7195/html5/thumbnails/10.jpg)
INTERACTIONS WITH OTHER DRUGS Anti-arrhythmics: increased myocardial
depresssion Antidepressants:meabolism of ropivacaine
inhibited by fluvoxamine(strong inhibitors of cytochrome P4501A2).
other local anaesthetics or agents : (structurally related to amide-type local anaesthetics)toxic effects of these drugs are additive.
![Page 11: Ropivacaine](https://reader036.vdocuments.pub/reader036/viewer/2022092623/58716eed1a28ab58758b7195/html5/thumbnails/11.jpg)
TREATMENT OF OVERDOSE: Celepid, a commonly available
intravenouslipid emulsion, can be effective in treating severe cardiotoxicity.
![Page 12: Ropivacaine](https://reader036.vdocuments.pub/reader036/viewer/2022092623/58716eed1a28ab58758b7195/html5/thumbnails/12.jpg)