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| Pronunciation | /roʊˈpɪvəkeɪn/ |
| Trade names | Naropin, Rocaine |
| AHFS/Drugs.com | Monograph |
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| Routes of administration | Parenteral |
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| Pharmacokinetic data | |
| Bioavailability | 87%–98% (epidural) |
| Metabolism | Liver (CYP1A2-mediated) |
| Eliminationhalf-life | 1.6–6 hours (varies with administration route) |
| Excretion | Kidney 86% |
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| ECHA InfoCard | 100.128.244 |
| Chemical and physical data | |
| Formula | C17H26N2O |
| Molar mass | 274.408 g·mol−1 |
| 3D model (JSmol) | |
| Melting point | 144 to 146 °C (291 to 295 °F) |
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Ropivacaine (rINN) is alocal anaesthetic drug belonging to theaminoamide group. The name ropivacaine refers to both theracemate and the marketedS-enantiomer. Ropivacaine hydrochloride is commonly marketed byAstraZeneca under the brand nameNaropin.
Ropivacaine was developed afterbupivacaine was noted to be associated withcardiac arrest, particularly in pregnant women. Ropivacaine was found to have lesscardiotoxicity than bupivacaine in animal models.
Ropivacaine is contraindicated forintravenous 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.[2]
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, howeverallergic reactions can rarely occur.
Systemic exposure to excessive quantities of ropivacaine mainly result incentral nervous system (CNS) andcardiovascular effects – CNS effects usually occur at lowerblood 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 andapnea). Cardiovascular effects includehypotension,bradycardia,arrhythmias, and/orcardiac arrest – some of which may be due tohypoxemia secondary to respiratory depression.[3]
Ropivacaine is toxic tocartilage and their intra-articular infusions can lead toPostarthroscopic glenohumeral chondrolysis.[4]
As forbupivacaine,Celepid, a commonly available intravenous lipid emulsion, can be effective in treating severe cardiotoxicity secondary to local anaesthetic overdose in animal experiments[5] and in humans in a process calledlipid rescue.[6][7][8]
