Indications
Ropivacaine is a long-acting local anaesthetic. It is used to numb part of the body for surgery (for example epidural or nerve block anaesthesia, including for caesarean section), and to control pain during labour and after operations, often as a continuous infusion through a fine tube (catheter).
How It Works
Ropivacaine blocks sodium channels in nerve cells, which stops nerves from sending pain signals to the brain. At lower strengths it mainly blocks pain while leaving more muscle movement than some older local anaesthetics.
Dosage and Administration
Ropivacaine is given only by an anaesthetist or trained doctor, by injection near nerves, into the epidural space or into the wound area, with monitoring equipment and resuscitation facilities available. The strength, amount and rate depend on the procedure, the patient’s size and health, and are as prescribed. It must never be injected into a vein by mistake.
Interactions
Other local anaesthetics and certain heart rhythm medicines (such as Lidocaine or Mexiletine) can add to its toxic effects. Fluvoxamine and some other medicines that block the liver enzyme CYP1A2 can raise its blood levels. Tell the doctor about all medicines you take.
Contraindications
Not used in people allergic to Ropivacaine or other amide-type local anaesthetics, for injection into a vein (intravenous regional anaesthesia), or in severe low blood pressure from blood loss (hypovolaemia) when used epidurally.
Side Effects
Common effects include low blood pressure, nausea, vomiting, slow heartbeat, headache, dizziness, tingling, back pain, fever and difficulty passing urine. Numbness and weakness in the blocked area are expected and wear off.
Tell the medical team at once about numbness around the mouth, a metallic taste, ringing in the ears, blurred vision, muscle twitching, confusion, chest pain or an irregular heartbeat, as these can be early signs of toxicity. Serious reactions such as seizures or heart rhythm problems are treated immediately by the team.
Pregnancy and Lactation
It is commonly used for labour pain and caesarean section when given by an anaesthetist. Small amounts may pass into breast milk; breastfeeding can usually continue after a single procedure, but follow the doctor’s advice.
Precautions and Warnings
Used with care in heart block, severe liver or kidney disease, elderly or weak patients, and those with low blood volume. After a nerve block, protect the numb area from injury, heat and pressure until feeling returns. Do not drive or use machines until the doctor says it is safe.
Overdose
Too much, or accidental injection into a blood vessel, can cause seizures, loss of consciousness, very low blood pressure and dangerous heart rhythms. This is treated straight away by the medical team.
Therapeutic Class
Amide local anaesthetic.
Storage
Store as directed on the pack, usually below 30°C; do not freeze. Hospital use only.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.